ArticlePloS one2022
Household access to non-communicable disease medicines during universal health care roll-out in Kenya: A time series analysis.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- A cluster-randomized trial of labelled cash transfers for uptake of care for chronic conditions among middle-aged and older adults in Burkina Faso.Nature human behaviour · 2026Trial
- Financial determinants of effective hypertension and diabetes care in rural primary health facilities in Kisumu, Kenya: a mixed-methods study.BMC public health · 2026Article
- Exploring factors affecting access to non-communicable disease medicines in low- and middle-income countries: a systematic review.BMJ public health · 2026Article
- Physical activity levels and its associated factors among adults in Vihiga county, Kenya.PLOS global public health · 2025Article
- Article
- The effect of a pilot universal health coverage program on hospital workload: A comparative study of two counties in Kenya.Dialogues in health · 2023Article
- Understanding the treatment burden of people with chronic conditions in Kenya: A cross-sectional analysis using the Patient Experience with Treatment and Self-Management (PETS) questionnaire.PLOS global public health · 2023Article
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to describe trends and estimate impact of county-level universal health coverage expansion in Kenya on household availability of non-communicable disease medicines, medicine obtainment at public hospitals and proportion of medicines obtained free of charge.
methodsData from phone surveillance of households in eight Kenyan counties between December 2016 and September 2019 were used. Three primary outcomes related to access were assessed based on patient report: availability of non-communicable disease medicines at the household; non-communicable disease medicine obtainment at a public hospital versus a different outlet; and non-communicable disease medicine obtainment free of cost versus at a non-zero price. Mixed models adjusting for fixed and random effects were used to estimate associations between outcomes of interest and UHC exposure.
resultsThe 197 respondents with universal health coverage were similar on all demographic factors to the 415 respondents with no universal health coverage. Private chemists were the most popular place of purchase throughout the study. Adjusting for demographic factors, county and time fixed effects, there was a significant increase in free medicines (aOR 2.55, 95% CI 1.73, 3.76), significant decrease in medicine obtainment at public hospitals (aOR 0.68, 95% CI 0.47, 0.97), and no impact on the availability of non-communicable disease medicines in households (aβ -0.004, 95% CI -0.058, 0.050) with universal health coverage.
conclusionsAccess to universal health coverage caused a significant increase in free non-communicable disease medicines, indicating financial risk protection. Interestingly, this is not accompanied with increases in public hospitals purchases or household availability of non-communicable disease medicines, with public health centers playing a greater role in supply of free medicines. This raises the question as to the status of supply-side investments at the public hospitals, to facilitate availability of quality-assured medicines.
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