Probability and amount of medicines expenditure according to health insurance status in Kenya: A household survey in eight counties.
BACKGROUND
National and county governments in Kenya have introduced various health insurance schemes to protect households against financial hardship as a result of large health expenditure. This study examines the relationship between health insurance and medicine expenditure in eight counties in Kenya.


METHODS
A cross-sectional study of collected primary data via household survey in eight counties was performed. Three measures of medicine expenditure were analysed: the probability of any out-of-pocket expenditure (OOPE) on medicines in the last 4 weeks; amount of OOPE on medicines; and OOPE on medicines as a proportion of total OOPE on health.


RESULTS
Out of the 452 individuals, those with health insurance (n = 225) were significantly different from individuals without health insurance (n = 227): overall, they were older, had a higher level of educational attainment and possessed more assets. Adjusting for covariates, individuals with health insurance had a reduced probability of OOPE on medicines (0.40, CI95% 0.197-0.827) and spent proportionally less on medicines out of total health expenditure (0.50, CI95% 0.301-0.926).


CONCLUSIONS
Kenya has made great strides to scale up Universal Health Coverage including access to medicines. Prioritising enrollment of low-income individuals with non-communicable diseases can accelerate access to medicines and financial protection.
['Wirtz|Veronika J|VJ|https://orcid.org/0000-0002-0863-8768', 'Servan-Mori|Edson|E|https://orcid.org/0000-0001-9820-8325', 'Mungai|John|J|', 'Mboya|John|J|', 'Rockers|Peter C|PC|', 'Onyango|Monica A|MA|', 'Kiragu|Zana Wangari|ZW|', 'Laing|Richard|R|']
medicines expenditure health insurance Kenya universal health coverage