• Outpatient services: Over the 10-year period between the first and third surveys, out of pocket spending declined in nominal terms, from KShs 61.5 billion in 2003 to KShs 43.9 billion in 2007, and then rose to KShs 62.1 billion in 2013, an increase of about 42 per cent. The average per capita spending for all health services (inpatient and outpatient) was KShs 1,609 in 2013, compared with KShs 1,181 in 2007 and KShs 1,913 in 2003. Outpatient care accounted for approximately 78 per cent (KShs 48.4 billion) of the total out-of-pocket spending on health, while inpatient services accounted for the rest (21.6%).

The average annual per capita spending on outpatient care was estimated at KShs 1,254. However, it varied greatly by demographic characteristics. For instance, females spent an average of KShs 1,469 on outpatient care compared to KShs 1,026 for males. Urban households spent on average KShs 1,733 compared to KShs 1,003 for rural households. On average, older segments of the population spent more on outpatient care than youth, with those 65 years and older having spent KShs 3,668, compared with KShs 1,783 for children under five years of age.

Additionally, wealthy households spent more on outpatient care than poor households (KShs 2,263 among the wealthiest households compared to KShs 703 among the poorest). On average, per capita spending on outpatient care for individuals with primary education was KShs 1,072, compared to KShs 1,647 for those with college and university educations. There was also considerable variation between counties. On average, Kajiado, Nairobi, Mombasa, and Kirinyaga counties spent above KShs 2,000, while Siaya and Turkana counties spent KShs 500.

• Inpatient services: Annual average per capita spending for inpatient services increased from KShs 343 in 2003 to KShs 505 in 2007. In 2013, the annual average per capita spending for inpatient services declined to KShs 355. However, variations were observed in 2013. Females spent, on average, KShs 400 compared to KShs 303 for males. The urban population spent an average of KShs 546 per capita on inpatient care compared to KShs 256 for the rural population, indicating a higher purchasing power among those residing in urban settings. Per capita spending on admissions also increased with levels of income/wealth. The richest wealth quintile spent KShs 928 per capita while the poorest spent KShs 136 per capita. On average, per capita, spending on inpatient care for individuals with post-primary/secondary education was KShs 392, compared to KShs 1,150 for those with college and university education. The survey also reported wide variations in per capita spending on inpatient care by county, with 15 counties spending more than the national average. For example, Nairobi county spent the most of any county at KShs 980, while Kilifi county spent the least (KShs 36 per capita).
• Catastrophic health spending: The proportion of households reporting catastrophic spending on health fell from 11.4 per cent in 2007 to 6.2 per cent in 2013. Despite this decline, thousands of Kenyan households continue to be pushed into poverty through health-related expenses.

Adopted from:2013 Kenya Household Health Expenditure and Utilization Survey

Healthcare in Kenya has improved over the years, as many patients continue to get insured. However, most households experience catastrophic healthcare spending resulting in sale of family assets, overburdening next of kin and community, Conducting fundraising “Harambees”, loans among other catastrophes. Is there anything we can do?

Medical Missions Africa, aims at having the marginalized, the poor and uninsured have access to free, compassionate, relevant and timely healthcare. We ask us to join by #AdoptAPatient by paying for NHIF insurance, Average healthcare expenditure, and/or any gift of sustainable livelihood in disease management.