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Historical account of the national health insurance formulation in Kenya: experiences from the past decade

Overview of attention for article published in BMC Health Services Research, February 2015
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1 tweeter

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18 Dimensions

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103 Mendeley
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Title
Historical account of the national health insurance formulation in Kenya: experiences from the past decade
Published in
BMC Health Services Research, February 2015
DOI 10.1186/s12913-015-0692-8
Pubmed ID
Authors

Timothy Abuya, Thomas Maina, Jane Chuma

Abstract

Many Low-and-Middle-Income countries are considering reviewing their health financing systems to meet the principles of Universal Health Coverage (UHC). One financing mechanism, which has dominated UHC reforms, is the development of health insurance schemes. We trace the historical development of the National Health Insurance (NHI) policy, illuminate stakeholders' perceptions on the design to inform future development of health financing policies in Kenya. We conducted a retrospective policy analysis of the development of a NHI policy in Kenya using data from document reviews and seven in depth interviews with key stakeholders involved in the NHI design. Analysis was conducted using a thematic framework. The design of a NHI scheme was marked by complex interaction of the actor's understanding of the design, proposed implementation strategies and the covert opposition of the reform due to several reasons. First, actor's perception of the cost of the NHI design and its implication to the economy generated opposition. This was due to inadequate communication strategies to articulate the policy, leading to a vacuum of factual information flow to various players. Secondly, perceived fear of implications of the changes among private sector players threatened support and success gained. Thirdly, underlying mistrust associated with perceived lack of government's commitment towards transparency and good governance affected active engagement of all key players dampening the spirit of collective bargain breeding opposition. Finally, some international actors perceived a clash of their role and that of international programs based on vertical approaches that were inherent in the health system. The thrust towards UHC using NHI schemes should not only focus on the design of a viable NHI package but should also involve stakeholder engagements, devise ways of improving the health care system, enhance transparency and develop adequate governance structures to institutions mandated to provide leadership in the reform process to overcome covert opposition.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 103 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Kenya 1 <1%
Ghana 1 <1%
Belgium 1 <1%
Unknown 99 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 27 26%
Researcher 14 14%
Student > Ph. D. Student 11 11%
Student > Bachelor 9 9%
Student > Postgraduate 8 8%
Other 20 19%
Unknown 14 14%
Readers by discipline Count As %
Medicine and Dentistry 29 28%
Social Sciences 19 18%
Economics, Econometrics and Finance 14 14%
Nursing and Health Professions 10 10%
Business, Management and Accounting 4 4%
Other 10 10%
Unknown 17 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 April 2015.
All research outputs
#2,658,526
of 5,007,280 outputs
Outputs from BMC Health Services Research
#1,473
of 2,237 outputs
Outputs of similar age
#89,758
of 154,380 outputs
Outputs of similar age from BMC Health Services Research
#66
of 90 outputs
Altmetric has tracked 5,007,280 research outputs across all sources so far. This one is in the 33rd percentile – i.e., 33% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,237 research outputs from this source. They receive a mean Attention Score of 4.5. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 154,380 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 90 others from the same source and published within six weeks on either side of this one. This one is in the 20th percentile – i.e., 20% of its contemporaries scored the same or lower than it.