PAYMENT STRATEGIES ON IMPLEMENTATION OF UNIVERSAL HEALTH COVERAGE: A CASE STUDY OF NATIONAL HOSPITAL INSURANCE FUND-TAITA TAVETA COUNTY IN KENYA

Abstract

National Hospital Insurance Fund plays an integral part as the driver towards UHC achievement in the country. Nevertheless, there is a need to evaluate effectiveness of its strategies geared to the achievement of UHC. Particularly with reference to efficiency, equity and quality of delivery of healthcare. In this regard, the objectives of the study were to determine the extent to which National Hospital Insurance Fund premium contributions rates, and the effect of capitation rates affects UHC implementation. The study was based on the conventional health insurance theory. Furthermore, the study relied on social exchange theory that espouses the concept of costs and benefits to predict behavior and that individuals chose strategies that helped them to incur low costs while keeping their reward high. The study also reviewed previous studies related to universal health coverage. The study then examined National Hospital Insurance Fund as a case study and its contents mainly: - benefit package and awareness, new premium contribution rates, and capitation. The data was analyzed using both descriptive and inferential statistics. The study established that the government provides a legal framework for ensuring a health care delivery system that is driven by the people while bridging the gap on geographical access by providing for a devolved system of governance. The study concludes that regular disbursements or what is known as capitation would greatly enhance sustainability of Universal Health Coverage. The study recommends an effective monitoring and evaluation systems for faster responses to health service needs so as to entrench universal health coverage.