NATIONWIDE PERCEPTION STUDY ON

UNIVERSAL HEALTH COVERAGE IN KENYA

 Background

All Kenyans are entitled to the highest attainable quality of affordable

healthcare according to Article 43 (1) (a) of the Constitution of Kenya.

Cognizant of this, the Jubilee government has included Universal Health

Coverage (UHC) as one of its Big Four Agenda items and committed to
Kenyans to achieve UHC by 2022.

As awareness creation takes place nationwide, UHC is also being piloted

in 4 counties namely; Kisumu, Machakos, Nyeri and Isiolo.

While much has been said by the government on UHC and the
transformed healthcare system, very little has been heard from the
citizenry.

It is against this background that The Infotrak Poll in conjunction with

the People’s Health Movement Kenya conducted a nationwide opinion
poll to understand the perception of Kenyans regarding UHC.
 Key Take Outs

Only 28% of Kenyans rated

Access to quality healthcare is health services delivery as
among the Top 10 concerns for “GOOD”. 40% of Kenyans
described health services as
Kenyans.
“POOR”, while 32% rated
them as “AVERAGE”.

The major problems that

Kenyans experience with UHC
A majority (69%) of Kenyans
are: Inadequate stock of drugs
are not aware of UHC,
and supplies in government
reflecting a lack of citizen
health facilities (39%) & Low
engagement on their health
numbers of doctors and nurses,
needs.
resulting in long queues and
waiting times (37%).
 About the Infotrak Poll on UHC

The Survey was sponsored by People’s Health Movement-Kenya

Who sponsored the poll?
(PHM-Kenya) and conducted by Infotrak Research and Consulting.

When was the poll conducted? Between 10th - 14th September 2019

The Poll was conducted using both telephone interviews and face to
How was the poll conducted?
face interviews with residents in the 4 UHC pilot counties.

A representative sample of 1200 respondents was interviewed in 24

What was the sample size? counties. A boost sample of 1056 interviews were conducted in the 4
UHC pilot counties i.e. Machakos, Nyeri, Isiolo and Kisumu.

What was the margin of error? +/- 3.0% at 95% degree of confidence

Using the National Household Population, the sample was designed

How was the sample designed?
using Probability Proportional to Size (PPS).

Data Analysis Data was processed and analyzed using SPSS 25

 1. 40% of Kenyans rate provision of healthcare services by both
national and county governments as Poor.
Only 28% rated provision of public healthcare services as good

Poor Average Good

% % %
Coast 44 21 35

North Eastern 38 25 37
Good Poor
28% 40% Eastern 33 35 32

Average Central 42 36 22
32%
Nairobi 43 29 28

Rift Valley 42 36 22

Western 30 34 36

On a scale of 1 – 5, where I is very poor and 5 is very good, Nyanza 42 32 26

how would you rate the government (both national and
county) in the provision of healthcare services? N=1200
Total 40 32 28
 2. A majority of Kenyans; 51% indicated that they do not have
any form of medical Insurance. Of those who have an
insurance, 89% indicated that they have NHIF

0% 20% 40% 60% 80%100%

Do you have any medical insurance
cover?
NHIF 89%
No Yes
51% 49%

UHC Card 8%
Yes No Total

Coast 37% 63% 100% Personal Medical

Cover 5%
North Eastern 45% 55% 100%

Eastern 62% 38% 100%

Central 62% 38% 100% Employer Provided

Medical Cover 5%
Nairobi 55% 45% 100%

Rift Valley 44% 56% 100%

Western 32% 68% 100% County Government

Medical Cover 1%
Nyanza 52% 48% 100%

Total 49% 51% 100%

N=1200
 3. 57% of Kenyans indicated that they have not visited a public
health facility in the past one year mainly because of poor
healthcare services in the facilities

Regions Yes No Total

Within the last one year, have you received
healthcare services from any of the public Coast 39% 61% 100%
healthcare facilities in your county?
North Eastern 33% 67% 100%
Yes Eastern 53% 47% 100%
43% Central 41% 59% 100%

No Nairobi 37% 63% 100%

57% Rift Valley 43% 57% 100%
Western 40% 60% 100%
Nyanza 46% 54% 100%
Total 43% 57% 100%
N=1200

Why have you not received healthcare services from public health institution in past one year?
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
Poor medical services in public facilities 47%
Inadequate public healthcare facilities 26%
Financial constraints 15%
Public healthcare facilities are located far 13%
Lack of time to visit healthcare facilities 7%
I self-medicate 7%
I use traditional medicine 2%
I use online medical solutions 1%
FOCUS ON UHC
What is Universal Health Coverage (UHC)?

Universal Health Coverage (UHC) is a

government program meant to ensure all
persons receive quality healthcare
services they need, without spending a lot
of money.

KEY FEATURES OF UHC

One has to be a Kenyan citizen.

One needs to register and obtain a UHC

card which will be issued by the National
Hospital Insurance Fund (NHIF) in various
health facilities. Registration is free.

One will be required to produce his/her

UHC card to access UHC services
 4. A majority of Kenyans; 69% are not aware of UHC, with pilot
counties registering higher awareness. Once the UHC concept was
explained to respondents, 82% rate the program as Important.

Now that the UHC concept has been

Are you aware of the Universal Health explained to you, how would you rate its
Coverage (UHC)? N=1200 importance on a scale of 1-5? N=1200
Not
Yes Important
31% 6%
Not Sure
12%
No
69%

Important
82%

Not
Yes No Not Sure Important
Important
Nyanza 45% 55% Western 1% 5% 94%
Central 40% 60% North Eastern 4% 4% 92%
Eastern 36% 64% Eastern 4% 12% 84%
Nairobi 33% 67% Nyanza 6% 10% 84%
Western 27% 73% Rift Valley 5% 13% 82%
Rift Valley 26% 74% Central 7% 14% 80%
CoastA majority (69%)20%
of 80% Coast 9% 16% 74%
North Eastern 13% 87% Nairobi 11% 20% 69%
Total 31% 69% Total 6% 12% 82%
 5. Kenyans’ wish list for UHC entails a package that covers both
public and private institutions; both inpatient & outpatient
services among other things

Facilities to be Covered Packages to be Covered

0% 20% 40% 60% 0% 20% 40% 60% 80%

All public and private

All inpatient services 69%
healthcare facilities 53%
All outpatient services 67%
All public healthcare Non - Communicable
facilities 34% 45%
diseases

All private healthcare Communicable diseases 36%

facilities 5%
Prenatal, Maternity and New
Born services 29%
Select public and private
4%
healthcare facilities Pediatric services 23%

Select public healthcare

2%
Dental Services 22%
facilities
Optical services 21%
Select private healthcare
facilities 1%
Specialized care 19%

Don't know 2% Don't Know 2%

Which healthcare facilities and packages would you wish the UHC cover to be applicable? N= 1141
FOCUS ON THE 4 UHC PILOT COUNTIES
ISIOLO, MACHAKOS, NYERI, KISUMU
 6. 42% of Kenyans in the UHC Pilot counties have registered for
UHC, with a majority of those who have registered coming form
older age cohorts.

UHC Registration in Pilot Counties Time of registration

Dont know/Can't Remember 8%

Yes A while ago (more than 6 months

42% ago but not more than one year) 58%
No Recently (within the last 3
58% months) 23%

Very recently (less than a month

ago) 5%

UHC Registration by age

42%
37%
32% 33%
29% 30%

18-25 Years 26-35 years 36-45 Years 46 – 55 Years 56 – 65 Years Above 65 years
N =1196
 7. All in all, a majority of people favor UHC because it is presented
as free during the pilot, but do not like health system gaps that
continue with UHC such as inadequate medicine.

What people like about UHC What people don’t like about UHC

0% 20% 40% 60% 80% 100% 0% 20% 40% 60%

Inadequate
Free treatment 85% 39%
medicine

So much time
Healthcare is taken before 37%
6%
accessible treatment

It is not in all
Caters for all in 20%
5% hospitals
society

There is provision Poor service

3%
of quality 4% delivery
healthcare
N =326
 8. The three key things Kenyans are advising Government to do to
make UHC a success are ; 1) UHC should cover both private and public
hospitals; 2) Government should increase medical supplies in health
facilities and, 3) UHC should cover all expenses,

0% 5% 10% 15% 20% 25% 30% 35% 40%

Should be used in all hospitals public &

private 36%

Increase medicine supply in health

facilities 30%

Cover all expenses/diseases/inpatient &

outpatient 28%

Register more people 4%

Others 1%

If the government asked for your advise on the best UHC plan. What would you advise them?
N= 504
 Demographics

50% Gender
42% Age
40%

30% 48%
21% 20% 52%
Male
20%
Female
8%
10% 6%
2%
0%
18-25 26-35 36-45 46 – 55 56 – 65 Above 65
Years years Years Years Years years

Level of Education 100% Religion 89.0%

None 4%
University post 80%
graduate 4%
University
10% 60%
undergraduate
Tertiary (college
and polytechnic) 24% 40%

Secondary 36% 20% 10%

1%
Primary 22% 0%
Other Muslim Christian

N=1200
 About People’s Health Movement Kenya

The People’s Health Movement – Kenya (PHM Kenya) is an independent civil society
network of health professionals in Kenya, including researchers, human rights defenders,
health activists, legal advisors, nurses, doctors and public health professionals.

PHM Kenya is part of the global People’s Health Movement, an international network of
health activists, professionals, researchers, civil society organizations and academic
institutions concerned by growing health inequalities and motivated by the call “Health
for All – NOW”. Grounded in the People’s Charter for Health
(https://phmovement.org/the-peoples-charter-for-health/). PHM leads in national and
global analysis of health and the systems that produce or undermine inequalities in
health.

PHM Kenya works to track, defend and promote the realization of the right to HEALTH
FOR ALL, as enshrined in Article 43 of the Constitution of Kenya.

Working with others in and beyond the health sector, PHM Kenya challenges the forces
of health inequalities and advocates for the fulfillment of health as a fundamental human
right for everyone in Kenya. They focus even more on vulnerable, poor or marginalized
people, including refugees and migrants, and especially women, girls and youth whose
rights to sexual and reproductive health is under threat.
 About Infotrak Research &
Consulting
“In the period culminating to the 2010 referendum on the
constitution in Kenya, Infotrak was the only pollster to
accurately predict the poll outcome reaffirming its
competence in sampling, data collection and analysis.” Infotrak Vision

• Infotrak Research and Consulting is a professional • To be the leading Market & Social research firm
research company that was founded and in Sub Saharan Africa
incorporated under the Laws of Kenya in 2004
following the vision of the founder to provide the
Pan African Market with suitable information
solutions required to sustain the needs of the
ever-growing economies. Infotrak Mission
• Headquartered in Nairobi, Kenya, Infotrak also
has affiliate offices in Nigeria, Uganda, Tanzania • To be a one stop, information solutions provider
and field contacts in more than 20 other to clients who want to be leaders in their fields.
countries in Sub Saharan Africa.
• The research and consultancy firm, which is
currently one of the fastest growing in the region,
attributes its rapid growth to not only innovation, Infotrak Belief
high level of professionalism and dynamism, but
also to the intricate attention given to providing
clients with relevant and user friendly reports. • Information is power. Only those who really
know how to use it become truly powerful. At
Infotrak, we place the power of information in
your hands!
 PHM KENYA CONTACTS:
INFOTRAK CONTACTS: peninahkhisa@gmail.com
raphael.mulwa@infotrakresearch.com collins@hakijamii.com
michael.omondi@infotrakresearch.com phm.esafrica@phmovement.org