Gender and disability disadvantage women in terms of pro-poor health financing policies in Kenya. How can we improve the system?

To extend financing coverage to the poor and vulnerable, Kenya has implemented several pro-poor health policy reforms since 2013:

1) The introduction of a free maternity programme

2) The abolition of user fees in public primary healthcare facilities (dispensaries and health centers)

3) The introduction of a Health Insurance Subsidy Programme (HISP) for the poor.

Health inequity has mainly been linked to differences in economic status, with poorer people facing greater challenges accessing healthcare and reporting worse health outcomes than the less poor. Other social determinants of health that influence health status and access to care include gender and disability. For example, women are more likely to experience poor health than men and people with disabilities are known to have increased need for healthcare services, but their health needs are more likely not to be met.

KEMRI Wellcome Trust undertook a study to explore how gender (being a woman), and disability intersect to influence the ability of the poor to benefit from pro-poor health financing policies in Kenya. This was a qualitative cross-sectional study done in two counties; one urban and one rural. The study entailed interviewing women with disabilities in the lowest wealth quintile residing in the health and demographic surveillance systems (HDSS) and those who were HISP beneficiaries in the two study counties.

This brief summarizes the key findings from the research and provides recommendations on how access barriers for women with disabilities living in poverty can be addressed.

By Evelyn Kabia, Rahab Mbau, Kui Muraya, Rosemary Morgan, Sassy Molyneux and Edwine Barasa

Brief on women with disabilities in Kenya