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Socio-Economic Determinants of Health Care Access among the Elderly in Kenya

Differences in access to healthcare are the main reason for existing disparities in healthcare provision among the elderly population in Kenya. Historically, the elderly population in Kenya has been somehow forgotten in the healthcare policy. Healthcare service provision in the country is delivered through the public and private (for profit and non-profit organisations) sectors. The state of a nation’s development can be greatly influenced by the state of population health. This is mostly determined by the way governments take health of their citizens philosophically. Healthcare Philosophy, the most important role of government in healthcare policy is to decide what healthcare is.. The key point of contention is whether healthcare is a commodity, or a human right. Those who see it as a commodity believe the government should generally defer to the private sector so that free enterprise might develop the most profitable healthcare system and individuals might purchase healthcare according to their ability to pay. Those who see healthcare as a human right believe that government should intervene to make healthcare available to everyone, regardless of the profit margins and regardless of individuals’ ability to pay. In the year 2014, President Uhuru Kenyatta launched the expanded Social Protection Plan, 2011, that sought to cover more than one million people that financial year under a multi-billion shilling program to cover an equal number of people in all constituencies. Basically, this included a monthly remuneration of Kshs. 2000 and free medical care for National Health Insurance Fund card holders in public health facilities. In spite of these efforts, healthcare access among the elderly is facing socio-economic challenges related to the following: Awareness and knowledge of available services; structural barriers; cultural belief systems and attitudes; income status; proximity to healthcare facilities; and stigma and discrimination associated with old age and elderly morbidity. A theoretical framework was identified on which the study was anchored. This study was conducted using a systematic review of social work interventions to extract socio-economic determinants of healthcare access among elderly people in Kenya. The Model of Healthcare Service Utilisation guided this study. This was a desktop analysis that utilised search engines to obtain data from various databases and e-libraries, which were guided by the purpose of the study. Thematically, fifty literature sources were reviewed to identify the extent to which these determinants influence healthcare access among the elderly population in Kenya. Social workers’ role in the eradication and alleviation of these hindrances to healthcare access were discussed. Conclusions and recommendations were drawn from this study including: The respondents rated well in services affordability (82.7%) and average in services acceptability (40.1%). However there were poor results in services availability (11.0%). Although these determinants have been examined to a greater extent, the extent to which these findings have been utilised is wanting. There still exists low house hold income, and low knowledge and awareness level of available services. There exists structural barriers that hinder access to service utilisation, cultural beliefs and attitudes that are also affecting the elderly, proximity to healthcare facilities, stigma and discrimination all which are also a big problems in our Kenyan society today. Key terms: Socio-economic; Healthcare; Access; Elderly
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