Effectiveness of NHIF in addressing Students’ Healthcare in Public Secondary Schools in Meru County, Kenya

Abstract

Health insurance helps cushion people from healthcare costs and facilitates equity in access to health facilities and services. The Government of Kenya has invested in a unique NHIF program, namely EduAfya, for public secondary schools. Although EduAfya is relatively new, it has faced implementation challenges attributable to the weak structures and mechanisms for supporting its operationalization. This study aimed to assess the NHIF as a health service provision model in public secondary schools in Meru County, Kenya. The specific objective was to examine the efficacy of NHIF as an approach for addressing healthcare in public secondary schools in Meru County. The study was guided by Andersen's model of health service utilization, and adopted a descriptive survey design. 395 Public secondary schools were stratified into four categories; hence, a proportionate systematic sampling technique was applied to sample 196 principals and the Students' Council's chairpersons, while the County Director of Education was sampled purposively. Data was collected using a self-administered questionnaire and interview guide. Quantitative data were analyzed using SPSS, where factor analysis, means and standard deviations were computed, while linear regression analysis was used to test the hypothesis. Qualitative data were analyzed using the thematic technique. The study noted that students were underutilizing the NHIF program (EduAfya) despite its significance in addressing their healthcare. This was attributed to low awareness, challenges in obtaining NEMIS numbers, and lack of understanding. Therefore, NHIF staff should conduct training and sensitization in public secondary schools, targeting students, principals, and parents. In addition, the Ministry of Education and NHIF should collaboratively liaise with stakeholders in accrediting more local health facilities, including private health centres, in order to enhance the proximity of access to healthcare. The government should also develop a clear policy on handling emergencies and transportation costs; streamline the issuance of NEMIS numbers and biometric cards, and clarify the role of principals in enhancing the effectiveness of EduAfya.