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Assessing National Health Insurance Fund members' level of understanding, experiences, and factors influencing their choice of contracted outpatient facilities in Kenya
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  • Jacob Kazungu,
  • Justice Nonvignon,
  • Matthew Quaife,
  • Edwine Barasa
Jacob Kazungu
KEMRI-Wellcome Trust Research Programme Nairobi

Corresponding Author:[email protected]

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Justice Nonvignon
University of Ghana School of Public Health
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Matthew Quaife
London School of Hygiene and Tropical Medicine Department of Infectious Disease Epidemiology
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Edwine Barasa
KEMRI-Wellcome Trust Research Programme Nairobi
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Objective: To assess National Health Insurance Fund (NHIF) members’ level of understanding, experiences, and factors influencing their choice of NHIF-contracted outpatient facilities in Kenya. Methods: We conducted a cross-sectional qualitative study with NHIF members in two purposefully selected counties (Nyeri and Makueni counties) in Kenya. We collected data through 15 focus group discussions with NHIF members. Data were analysed using a framework analysis approach. Results: Urban-based NHIF members had a good understanding of the NHIF-contracted outpatient facility selection process and the approaches for choosing and changing providers, unlike their rural counterparts. While NHIF members were required to choose a provider before accessing care, the number of available alternative facilities was perceived to be inadequate. Finally, NHIF members identified seven factors they considered important when choosing an NHIF-contracted outpatient provider. Of these factors, the availability of drugs, distance from the household to the facility and waiting time at the facility until consultation were considered the most important. Conclusion: There is a need for the NHIF to prioritise awareness-raising approaches tailored to rural settings. Further, there is a need for the NHIF to contract more providers to both spur competition among providers and provide alternatives for members to choose from. Besides, NHIF members revealed the important factors they consider when selecting outpatient facilities. Consequently, NHIF should leverage the preferred factors when contracting healthcare providers. Similarly, healthcare providers should enhance the availability of drugs, reduce waiting times whilst improving their staff’s attitudes which would enhance user satisfaction and the quality of care provided.
15 Apr 2023Submitted to International Journal of Health Planning and Management
19 Apr 2023Review(s) Completed, Editorial Evaluation Pending
19 Apr 2023Submission Checks Completed
19 Apr 2023Assigned to Editor
19 Apr 2023Reviewer(s) Assigned
19 May 2023Editorial Decision: Revise Major
23 May 20231st Revision Received
24 May 2023Assigned to Editor
24 May 2023Review(s) Completed, Editorial Evaluation Pending
24 May 2023Submission Checks Completed
25 May 2023Reviewer(s) Assigned
04 Jul 2023Editorial Decision: Revise Minor
12 Jul 20232nd Revision Received
13 Jul 2023Assigned to Editor
13 Jul 2023Review(s) Completed, Editorial Evaluation Pending
13 Jul 2023Submission Checks Completed
13 Jul 2023Reviewer(s) Assigned
16 Jul 2023Editorial Decision: Accept