The impact of digital health insurance for low-income women in Kenya

Amanuel Abajobir, African Population and Health Research Center (APHRC)
Richard de Groot, AIGHD
Caroline Wainaina, African Population and Health Research Center (APHRC)
Estelle Sidze, Université de Montréal
Menno Pradhan, APHRC
Wendy Janssens, AIGHD

This study evaluates how a subsidized, mobile phone-based health insurance program affected insurance uptake, healthcare utilization and health expenditures for low-income women and their family members in Western Kenya. The research was based on a cluster-RCT in 24villages in Kakamega County. After a baseline survey, 240 households (more than 1,300individuals) were interviewed every week during 18 months to collect detailed financial and health data while the program was rolled out in the treatment communities. The intervention had a significant impact on individual insurance uptake of 65.8 percentage points (from a baseline control mean 18.9 percent). We find weak positive impacts on formal healthcare utilization, and substantial increases in financial coverage of medical costs and associated reductions in out-of-pocket expenditures, particularly for medicines. Results are strongest for women, young children and individuals living closest to the clinics. Dynamic analyses show that impacts become increasingly pronounced over time, suggesting that women may need some time to get used to the digital insurance scheme. The program not only reduced the costs of enrolment, but also eliminated other (administrative, logistical, trust) barriers. Digital insurance has the potential to substantially enhance universal health coverage and financial protection for poor households.

Keywords: Health and Morbidity, Children, Adolescents, and Youth

See extended abstract.