Modeling the socioeconomic determinants of health insurance coverage among boda-boda riders in Kenya

Abstract

Achieving universal health coverage remains a major challenge in low- and middle-income countries such as Kenya, especially for vulnerable groups like informal workers. This study focuses on boda-boda riders, an important part of Kenya’s transport sector, who often do not have access to formal health insurance. The aim of the study was to examine how socioeconomic factors influence health insurance enrollment among boda-boda riders in Kenya, with the goal of supporting fair access to healthcare. A descriptive cross-sectional design was used, and data were collected from 370 boda-boda riders in Embu County, Kenya, using a structured questionnaire. The questionnaire gathered information on socioeconomic characteristics, insurance enrollment status, perceived affordability of health insurance, and demographic details. Logistic regression was used to assess the effect of these factors on the likelihood of enrolling in health insurance. Results showed that 62.2% of participants had health insurance. The analysis found that riders with higher income (OR = 1.000, p < 0.001), more working hours per week (OR = 1.655, p < 0.001), and older age (OR = 1.270, p < 0.001) were more likely to be enrolled. In contrast, having more dependents (OR = 0.385, p < 0.001) and more years of experience in the boda-boda business (OR = 0.118, p < 0.001) were linked to a lower chance of enrollment. Additionally, those who viewed health insurance as affordable were significantly more likely to enroll (OR = 4.529, p < 0.001) compared to those who saw it as expensive. These findings highlight that both socioeconomic status and the perceived cost of insurance are key factors affecting enrollment in health insurance among boda-boda riders in Kenya.