The relationship between a microfinance-based healthcare delivery platform, health insurance coverage, health screenings, and disease management in rural Western Kenya

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.

Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

“…A study in Malawi similarly found lower out-of-pocket costs for patients in integrated care, compared to non-integrated care [63]. Intersectoral financing and/or community-based micro-financing to address both multiple determinants of health are also being explored as options to support the scale-up of integrated care [64,65]. Further, many elements of the health system put in place or strengthened for infectious disease prevention and treatment can be applied to NCD care and emerging pathogen needs, or vice versa (Table 1) [42,66].…”

A Global Health Reciprocal Innovation grant programme: 5-year review with lessons learnt

“…No investigators opted for the phone survey, but we received surveys from nine I-CTSI grantees and four LMIC cograntees, a response rate of 100% and 66%, respectively. As shown in table 2, 69% of survey participants stated the funding led to publications including abstracts, posters and manuscripts, with a total of 18 manuscripts published or submitted at the time of the survey 7–21. In addition, 69% of the respondents stated the funding led to further grant applications, with 38% of those applications resulting in successful funding.…”

“…As shown in table 2, 69% of survey participants stated the funding led to publications including abstracts, posters and manuscripts, with a total of 18 manuscripts published or submitted at the time of the survey. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, 69% of the respondents stated the funding led to further grant applications, with 38% of those applications resulting in successful funding. Most notably, 92% of all participants felt the funding mechanism helped All the respondents provided positive statements regarding RI potential to highlight mutual learning, building partnerships and collaborations, and shared innovation between contexts.…”

Maintaining care delivery for non-communicable diseases in the face of the COVID-19 pandemic in western Kenya

“…In recognition of the growing NCD burden in Kenya, AMPATH has established a chronic disease management program in collaboration with the Kenya Ministry of Health (MOH), operating in over 150 health facilities spanning all levels of the public sector health care system in western Kenya [ 3 ]. Over the past decade, the program has provided multicomponent care to over 40,000 individuals with hypertension and/or diabetes, grounded in the following principles: partnership with communities and governments [ 4 ], geographic decentralization of care, task redistribution [ 5 ], continuous supply of medications [ 6 ], group medical visits [ 7 ], and incorporation of social determinants of health into care delivery [ 8 ].…”