ArticleBMC public health2020
Access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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27 citing papers in PubMed.
- Intersectional inequalities in healthcare utilisation in informal settlements in Freetown, Sierra Leone: a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).International journal for equity in health · 2026Article
- Factors influencing access to primary healthcare services among households in urban slums of Mogadishu, Somalia: a cross-sectional study.BMC health services research · 2026Article
- How health systems factors, socioeconomic status, and care-seeking practices influence the cost of rotavirus-related diarrhea care in Mukuru informal settlements, Kenya.Frontiers in public health · 2026Article
- "Now I feel like I can": exploring e-commerce for self-care contraception in Kenya.Frontiers in global women's health · 2026Article
- A critical interpretive synthesis of the constructed identities and experiences of refugees, asylum seekers, and undocumented migrants in relation to accessing primary care services in the UK.Journal of migration and health · 2026Review
- Unmet need for health care services among Rohingya Refugees living in Cox's Bazar and Bhasan Char in Bangladesh.PLOS global public health · 2026Article
- Determinants of sleep quality among women living in informal settlements in Kenya.BMC women's health · 2025Article
- Catastrophic health expenditure, social protection coverage, and financial coping strategies in adults with symptoms of chronic respiratory diseases in Kenya: a cross-sectional study.The Lancet. Global health · 2025Article
- Knowledge, confidence and social support: Kenyan women's priority needs for contraceptive self-injection learning through a social cognitive theory lens.BMC women's health · 2025Article
- Barriers to healthcare access among female youths in Mozambique: a mixed-effects and spatial analysis using DHS 2022/23 data.BMC public health · 2025Article
- Financial barriers and inequalities in healthcare access across East Africa: evidence from demographic and health surveys.Frontiers in reproductive health · 2025Article
- Understanding demographic events and migration patterns in two urban slums of Nairobi City in Kenya.Scientific reports · 2024Article
- Barriers of access to primary healthcare services by National Health Insurance Fund capitated members in Uasin Gishu county, Kenya.BMC health services research · 2024Article
- Extreme weather should be defined according to impacts on climate-vulnerable communities.Nature climate change · 2024Article
- Socio-ecological impacts of extreme weather events in two informal settlements in Nairobi, Kenya.Frontiers in public health · 2024Article
- Help-seeking behavior for nonsevere stress urinary incontinence among elderly women in communities, Beijing, China.International urogynecology journal · 2023Article
- Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021.Archives of public health = Archives belges de sante publique · 2023Article
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7 authors.
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Abstract
backgroundAccess to primary healthcare is crucial for the delivery of Kenya's universal health coverage policy. However, disparities in healthcare have proved to be the biggest challenge for implementing primary care in poor-urban resource settings. In this study, we assessed the level of access to primary healthcare services and associated factors in urban slums in Nairobi-Kenya.
methodsThe data were drawn from the Lown scholars' study of 300 randomly selected households in Viwandani slums (Nairobi, Kenya), between June and July 2018. Access to primary care was measured using Penchansky and Thomas' model. Access index was constructed using principal component analysis and recorded into tertiles with categories labeled as poor, moderate, and highest. Generalized ordinal logistic regression analysis was used to determine the factors associated with access to primary care. The adjusted odds ratios (AOR) and 95% confidence intervals were used to interpret the strength of associations.
resultsThe odds of being in the highest access tertile versus the combined categories of lowest and moderate access tertile were three times higher for males than female-headed households (AOR 3.05 [95% CI 1.47-6.37]; p < .05). Households with an average quarterly out-of-pocket healthcare expenditure of ≥USD 30 had significantly lower odds of being in the highest versus combined categories of lowest and moderate access tertile compared to those spending ≤ USD 5 (AOR 0.36 [95% CI 0.18-0.74]; p < .05). Households that sought primary care from private facilities had significantly higher odds of being in the highest versus combined categories of lowest and moderate access tertiles compared to those who sought care from public facilities (AOR 6.64 [95% CI 3.67-12.01]; p < .001).
conclusionIn Nairobi slums in Kenya, living in a female-headed household, seeking care from a public facility, and paying out-of-pocket for healthcare are significantly associated with low access to primary care. Therefore, the design of the UHC program in this setting should prioritize quality improvement in public health facilities and focus on policies that encourage economic empowerment of female-headed households to improve access to primary healthcare.
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