Original Article
 
Health insurance status of female caregivers and its effect on the utilization of oral healthcare for children with HIV/AIDS in Nairobi, Kenya
Masiga Mary Atieno1, Wandibba Simiyu2
1Associate Professor, Department of Pediatric Dentistry and Orthodontics, College of Health Sciences, University of Nairobi, Nairobi, Kenya
2Professor, Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya

Article ID: 100027D01MA2017
doi:10.5348/D01-2017-27-OA-7

Address correspondence to:
Mary Atieno Masiga
P.O. Box 48792 00100
Nairobi, Kenya

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How to cite this article
Masiga MA, Wandibba S. Health insurance status of female caregivers and its effect on the utilization of oral healthcare for children with HIV/AIDS in Nairobi, Kenya. Edorium J Dent 2017;4:38–44.


ABSTRACT

Aims: Dental caries is a public health concern in many developing nations like Kenya. Slum children often do not have access to oral health care, and their oral health-related quality of life (OHRQoL) remains largely un-researched topic in Kenya. The present study was designed to determine the prevalence and severity of dental caries and its impact on the OHRQoL of a cohort of slum-dwelling children in a Nairobi slum.
Methods: This was a hospital-based mixed methods cross-sectional study carried out at the out-patient HIV-care clinics at Getrude Children’s hospital (GCH), Kenyatta National Hospital (KNH) and Mbagathi County and Referral Hospital (MCRH) in Nairobi City County, Kenya. The study involved 221 female caregivers of children with HIV/AIDS and their health workers at the HIV-care clinics.
Results: More than two-thirds (68%) of the respondents did not have any form of health insurance to facilitate access to medical and/or dental healthcare. More than three quarters (76%) of those who had utilized oral healthcare services for their children paid from out-of-pocket (OOP) expenses. There was gross underutilization of the National Health Insurance Fund, NHIF, with only 18% of the respondents having been enrolled.
Conclusion: Underutilization of social health insurance by caregivers, compounded by OOP spending for health services imposes limitations on the utilization of oral healthcare for children with HIV/AIDS.

Keywords: Health insurance oral healthcare, Children with HIV/AIDS

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Acknowledgements
We acknowledge the administrators of the HIV-care facilities where the study was undertaken for permission to carry out the study and facilitating the field work and data collection, and the caregivers of children with HIV/AIDS who participated in the study. We also acknowledge Mr. Godfrey Ngugi and Ms Elizabeth Wambui for assistance with data analysis, and Ms. Carol Owala and Ms. Catherine Odawo for secretarial services.

Author Contributions
Mary Atieno Masiga – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Simiyu Wandibba – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Mary Atieno Masiga et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.