The relationship between a microfinance-based healthcare delivery platform, health insurance coverage, health screenings
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(2020) 20:868
RESEARCH ARTICLE
Open Access
The relationship between a microfinancebased healthcare delivery platform, health insurance coverage, health screenings, and disease management in rural Western Kenya Molly Rosenberg1* , James Akiruga Amisi2,3, Daria Szkwarko2,4,5,6, Dan N. Tran2,7, Becky Genberg8,9, Maya Luetke1, Sina Kianersi1, Jane Namae10, Jeremiah Laktabai2,3 and Sonak Pastakia2,7
Abstract Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of these barriers. This study evaluated the association between participation in BIGPIC microfinance groups and health screening/disease management outcomes. Methods: From November 2018 to March 2019, we interviewed a sample of 300 members of two rural communities in Western Kenya, 100 of whom were BIGPIC microfinance members. We queried participants about their experiences with health screening and disease management for HIV, diabetes, hypertension, tuberculosis, and cervical cancer. We used log-binomial regression models to estimate the association between microfinance membership and each health outcome, adjusting for key covariates. Results: Microfinance members were more likely to be screened for most of the health conditions we queried, including those provided by BIGPIC [e.g. diabetes: aPR (95% CI): 3.46 (2.60, 4.60)] and those not provided [e.g. cervical cancer: aPR (95% CI): 2.43 (1.21, 4.86)]. Microfinance membership was not significantly associated with health insurance uptake and disease management outcomes. Conclusions: In rural Kenya, a microfinance program integrated with healthcare delivery may be effective at increasing health screening. Interventions designed to thoughtfully and sustainably address structural barriers to healthcare will be critical to improving the health of those living in low-resource settings. Keywords: Microfinance, Health insurance, Health screening, Kenya
* Correspondence: [email protected] 1 Department of Epidemiology and Biostatistics, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, Indiana, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended us
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