Against a background of limited access to healthcare services, this paper
examines the factors that influence household access to healthcare services in
Eldoret municipality, Kenya. The main objective of the study was to identify
the factors that influence household access to healthcare services in the municipality.
The study was guided by the following specific objectives: to investigate the
socio-economic factors that influence household access to healthcare services;
to assess the influence of health insurance on household access to healthcare services; and to establish the
influence of referral system on household access to healthcare services.
It is hoped that the results of the study will improve policy-makers
understanding on factors that influence access to healthcare services and to
serve as an important tool for any possible intervention aimed at improving
access to healthcare. Health Belief Model (HBM) is employed as the theoretical
framework. Research design takes survey form. The unit of analysis constituted
household heads in the municipality. Stratified, systematic, purposive and
convenience sampling procedures were used to arrive at a sample size of two
hundred and sixty household heads. Data was derived from both primary and
secondary sources and analyzed using Statistical Package for the Social
Sciences (SPSS) to ascertain statistical relationships between variables. The
findings indicate that: there are specific urban dimensions on access to
healthcare; among the respondents, there is substantial unmet healthcare
need; and for many urban families using healthcare services is determined by
much more than being able to reach them physically. Itfurther answers the questions: do socio-economic
characteristics, health insurance and referral system have any role in access
to healthcare? Besides, the findings of the study raise new areas
for further research in healthcare.
References
[1]
Al-Mazrou, Y., Al-Shehri, S., & Rao, M. (1990). Principles and Practice of Primary Health Care. Al-Helal Press.
[2]
Andersen, R. M. (1995). Revisiting the Behavioural Model and Access to Medical Care: Does It Matter? Journal of Health and Social Behaviour, 36, 1-10. https://doi.org/10.2307/2137284
[3]
Andersen, R. M., & Newman, J. F. (1973). Societal and Individual Determinants of Medical Care Utilization in the United States. Milbank Memorial Fund Quarterly Journal, 51, 95-124. https://doi.org/10.2307/3349613
[4]
Arksey, H., Jackson, K., Wallace, A., Baldwin, S., Golder, S., Newbronner, E., & Hare, P. (2003). Access to Health Care for Carers: Barriers and Interventions. National Coordinating Centre for NHS Service Delivery and Organisation.
[5]
Babbie, E. (1992). The Practice of Social Research (6th ed.). Wadsworth.
[6]
Baeza, C. C., & Packard, T. G. (2006). Beyond Survival: Protecting Households from Health Shocks in Latin America. Stanford University Press. https://doi.org/10.1596/978-0-8213-6571-7
[7]
Becker, M. H. (1974). The Health Belief Model and Personal Health Behaviour. Society for Public Health Education, Inc. https://doi.org/10.1177/109019817400200407
[8]
Bedi, A. S., Kimalu, P., Kimenyi, M. S., Manda, D. K., Mwabu, G., & Nafula, N. (2004). User Charges and Utilization of Health Services in Kenya. Discussion Paper Series No. 32, The Kenya Institute for Public Policy Research and Analysis (KIPPRA).
[9]
Carr, D. (2004). Improving the Health of the World’s Poorest People. Health Bulletin 1, Population Reference Bureau.
[10]
Celik, Y., & Hotchkiss, D. R. (2000). The Socio-Economic Determinants of Maternal Health Care Utilization in Turkey. Social Science Medicine, 50, 1797-1806. https://doi.org/10.1016/S0277-9536(99)00418-9
[11]
Detels, R., McEwen, J., Beaglehole, R., & Tanaka, H. (2004). Oxford Textbook of Public Health Fourth Edition. Oxford University Press.
[12]
Dina, L. A., & Law, A. L. (1998). Questions of Gender: Perspectives and Paradoxes. The McGraw-Hill Companies, Inc.
[13]
Diop, F., Yazbeck, A., & Bitran, R. (1995). The Impact of Alternative Cost Recovery Schemes on Access and Equity in Niger. Health Policy and Planning, 10, 223-240. https://doi.org/10.1093/heapol/10.3.223
[14]
Dorling, D., & Simpson, S. (1999). Statistics in Society: The Arithmetic of Politics. Arnold.
[15]
Filmer, D., Hammer, J., & Pritchett, L. (1997). Health Policy in Poor Countries: Weak Links in the Chain. Policy Research Working Paper 1874, World Bank.
[16]
Freeman, H. E., Levine, S., & Reeder, G. R. (1994). A Handbook of Medical Sociology. Prentice Hall, Inc.
[17]
Goldstein, S., & Price, M. (1995). Utilization of Primary Curative Services in Diepkloof, Soweto. South African Medical Journal, 85, 505-508.
[18]
Heenan, D. (2006). The Factors Influencing Access to Health and Social Care in the Farming Communities of County Down, Northern Ireland. Ageing and Society, 26, 373-391. https://doi.org/10.1017/S0144686X06004697
[19]
Hensher, M., Price, M., & Adomokoh, S. (2006). Referral Hospitals: Disease Priorities in Developing Countries. Oxford University Press.
[20]
Hochbaum, G. M. (1958). Public Participation in Medical Screening Programs: A Sociopsychological Study. PHS Publication No. 572, Government Printing Office.
[21]
Iyer, A. (2005). Gender, Caste, Class and Health Care Access: Experience of Rural Households in Koppal District, Karnataka, Trivandum, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal. Institute for Medical Sciences and Technology.
[22]
Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A Decade Later. Health Education Quarterly, 11, 1-47. https://doi.org/10.1177/109019818401100101
[23]
Kiranandana, T., & Apaivratr, S. (1990). Evaluation of Health Card Project: A National Census. Military Warfare Organization.
[24]
Kirigia, J. M., Gbary, A. P., Muthuri, L. K., Nyoni, J., & Seddoh, A. (2006). The Cost of Health Professionals’ Brain Drain in Kenya. BMC Health Services Research, 6, 89. https://doi.org/10.1186/1472-6963-6-89
[25]
Leonard, D. K. Ed. (2000). Africa’s Changing Markets for Health and Veterinary Services: The New Institutional Issues. Macmillan Press Ltd.
[26]
Lorber, J., & Moore, L. J. (2002). Gender and the Social Construction of Illness. Rowman & Littlefield.
[27]
MacIntyre, C. R. (2020). Global Spread of COVID-19 and Pandemic Potential. Global Biosecurity, 2, 1-3. https://doi.org/10.31646/gbio.55
[28]
March, C., Smyth, I., & Mukhopadhyay, M. (1999). A Guide to Gender-Analysis Frameworks. Oxfam. https://doi.org/10.3362/9780855987602
[29]
Mekkonen, Y., & Mekkonen, A. (2003). Factors Influencing the Use of Maternal Healthcare Services in Ethiopia. Journal of Health, Population and Nutrition, 21, 374-382.
[30]
Ministry of Health (MOH) (1997). A Question of Survival? Review of Safe Motherhood. Ministry of Health, Division of Primary Health Care.
[31]
Misau, Y. A., Al-Sadat, N., & Gerei, A. B. (2010). Brain-Drain and Health Care Delivery in Developing Countries. Journal of Public Health in Africa, 1, e6. https://doi.org/10.4081/jphia.2010.e6
[32]
Musgrove, P., Ed. (2004). Health Economics in Development. Washington DC: The World Bank.
[33]
Mwabu, G., Wang’ombe, J., Okello, D., & Munishi, G. (2004). Improving Health Policy in Africa. University of Nairobi Press.
[34]
Nyakaana, J. B. (1996). Kenya’s Development Centre Policy: The Case of Eldoret an Assessment of Its Implementation and Impact. Drukkerij Elinkwij b.v. Utrecht.
[35]
O’Reilly, D., Stevenson, M., McCay, C., & Jamison, J. (2001). General Practice Out of Hours Service, Variations in Use and Equality in Access to a Doctor: A Cross-Sectional Study. British Journal of General Practice, 51, 625-629.
[36]
Odada, J. E. O., & Ayako, A. B. (1988). The Impact of Structural Adjustment Policies on the Wellbeing of the Vulnerable Groups in Kenya. English Press Ltd.
[37]
Oleske, D. M. (2001). Epidemiology and the Delivery of Health Care Services. Kluwer Academic/Plenum Publishers. https://doi.org/10.1007/b112328
[38]
Patrick, D. L., & Erickson, P. (1993). Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. Oxford University Press.
[39]
Penchansky, R., & Thomas, J. W. (1981). The Concept of Access: Definition and Relationship to Consumer Satisfaction. Medical Care, 19, 127-140. https://doi.org/10.1097/00005650-198102000-00001
[40]
Preker, A. S., & Carrin, G. (2004). Health Financing for the Poor People: Resource Mobilization and Risk Sharing. The World Bank. https://doi.org/10.1596/0-8213-5525-2
[41]
Preker, A. S., & Feachem, R. G. A. (1996). Market Mechanisms and Health Sector in Central and Eastern Europe. World Bank Technical Paper No. 293. https://doi.org/10.1596/0-8213-3331-3
[42]
Republic of Kenya (1997). Uasin Gishu District Development Plan 1997-2001. Government Printer.
[43]
Republic of Kenya (2001). 1999 Population and Housing Census. Government Printer.
[44]
Republic of Kenya (2002a). National Development Plan 2002-2008: Effective Management for Sustainable Economic Growth and Poverty Reduction. Government Printer.
[45]
Republic of Kenya (2002b). Uasin Gishu District Development Plan 2002-2008: Effective Management for Sustainable Economic Growth and Poverty Reduction. Government Printer.
[46]
Republic of Kenya (2005). Uasin Gishu District Strategic Plan 2005-2010 for Implementation of the National Population Policy for Sustainable Development. NCAPD.
[47]
Republic of Kenya. (2009). End Term Review of the Economic Recovery Strategy for Wealth and Employment Creation (ERS) 2003-2007. Nairobi: Government Printer.
[48]
Republic of Kenya (2010). The 2009 Kenya Population and Housing Census, Counting Our People for the Implementation of Vision 2030 Volume 1A: Population Distribution by Administrative Units. KNBS.
[49]
Rosenstock, I. M. (1966). Why People Use Health Services. Milbank Memorial Fund Quarterly, 44, 94-124. https://doi.org/10.2307/3348967
[50]
Rosenstock, I. M. (1974). Historical Origins of the Health Belief Model. Health Education Monographs, 2, 328-335. https://doi.org/10.1177/109019817400200403
[51]
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social Learning Theory and the Health Belief Model. Health Education Quarterly, 15, 175-183. https://doi.org/10.1177/109019818801500203
[52]
Scambler, G. (2003). Sociology as Applied to Medicine (5th ed.). Saunders.
[53]
Tones, K., & Tilford, S. (2001). Health Promotion: Effectiveness, Efficiency and Equity. Nelson Thornes Ltd.
[54]
Wavamunno, M. D., & Harris, D. C. H. (2005). The Need for Early Nephrology Referral. Kidney International, 67, S128-S132. https://doi.org/10.1111/j.1523-1755.2005.09429.x
[55]
Williams, S. J., & Torrens, P. R. (2008). Introduction to Health Services (7th ed.). Thomson Delmar Learning.
[56]
World Health Organization (2000). World Health Report 2000: Health Systems-Measuring Performance. WHO.
[57]
World Health Organization (2004). Kenya Country Office: Annual Report. WHO.
