DETERMINING BASELINE HEALTH INSURANCE COVERAGE AND LOCATION OF BIRTH IN CHILDREN PRESENTING WITH PEDIATRIC SURGICAL CONDITIONS IN A RURAL AND REFUGEE SETTING nkaseje@gmail.com

 

DETERMINING BASELINE HEALTH INSURANCE COVERAGE AND LOCATION OF BIRTH IN CHILDREN PRESENTING WITH PEDIATRIC SURGICAL CONDITIONS IN A RURAL AND REFUGEE SETTING

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Kenya

Oral or Poster

Access to pediatric surgical care remains poor in rural and refugee contexts. Significant barriers to access include poverty and for neonates deliveries at home. Our objective was to determine baseline health insurance coverage and birth location to guide future interventions to improve access to pediatric surgical care in rural and refugee contexts.

We prospectively collected data on health insurance coverage and location of birth in children presenting to the Lodwar County referral hospital in Turkana Kenya for surgical services. We retrospectively examined demographic characteristics, health insurance coverage, and location of birth. We conducted descriptive statistical analyses and calculated means and frequencies.

The mean age of children presenting with pediatric surgical conditions was 5.4 years (range 4 days old to 15 years old, n= 101). Only eight of the 101 children had health insurance coverage (7.9%), while 93 did not (92.1%), primarily due to lack of money. Thirty four out of the 101 children were born at home (33.7%). The most common surgical diagnoses were hernias (inguinal and umbilical hernias) and hydroceles.

In this particular rural and refugee context, significant proportions of children in need of surgical services had no health insurance and were born at home. To reduce barriers to accessing surgical services in these settings, more interventions are needed to increase health insurance coverage and to promote facility-based deliveries, thereby improving the availability and utilization of pediatric surgical care.