Socio-Economic Determinants of NHIF Enrollment by Self-employed Residents of Nyeri Central Sub-County, Nyeri County, Kenya

Health care has always been a problem area for many nations, including Kenya, with a large population and a substantial portion living below the poverty line. Out of pocket payment is the predominant means of health care financing in the majority of developing countries including Kenya. The purpose of this study was to investigate National Hospital Insurance Fund (NHIF) enrolment on self-employed residents in Nyeri central sub-county, Nyeri County. The study was guided by four specific objectives: to determine influence of demographic characteristics of self-employed residents on the enrolment of NHIF cover, to establish the relationship between socio-economic status of self-employed residents and enrolment of NHIF cover, to investigate how level of awareness affect NHIF enrolment by self-employed residents and to determine influence of accessibility of health services on NHIF enrolment by self-employed residents.Data was collected from a sample of 306 respondents using questionnaires and thereafter analyzed using SPSS software to generate frequency distributions and measures of central tendency such as mean and standard deviation. The results indicate that more females (28.7%) as compared to male (23.2%) had enrolled to NHIF. Those aged between 36-45 years (17.7%) had enrolled for NHIF. Those who were married (29.7%) were also enrolled. Those who had the size of the household of 3-5 (28.3%) were also enrolled. Education level for those who had gone up to college level (46.8%) were enrolled. Enrollment was also high for people with higher incomes and those who were affiliated to social welfare groups. The awareness of NHIF registration procedures, premium payment mechanisms and the benefit packages was low and this greatly influenced the uptake of the cover. The study concluded that demographic factors (including gender, age, marital status, household size and education level), socio-economic factors, awareness and accessibility had an influence on the enrolment to NHIF for the self employed residents. The study recommends that NHIF increases awareness of benefits by using various media platforms including vernacular stations. Further the study recommends the government to educate people in the informal sector particularly the self-employed to access finance so as increase their level of income to be able to pay for premiums. Further studies should be done on the reasons why self-employed workers register and withdraw.