IJPP

P 159-173Health systems are a means to achieving better health outcomes for all. However, where patients depend largely on out of pocket (OOP) payments to access health services, there is often lack of care for those who cannot afford. This study aimed at establishing the fac¬tors influencing the demand for health insurance among Jua Kali workers in Nairobi. This was a cross-sectional research study involving mixed approach (simple random, purposive sampling, qualitative and quantitative methods) involving 130 Jua Kali workers from Associations/Cooperatives and 258 Jua Kali workers from non-organized groups; key informants from NHIF and the Department of Micro and Small Enterprise Department and was. The study was conducted between January to March 2012 within Pumwani Division in Nairobi County. Findings indicated that 113 (29.1%); 21.1% members of Jua Kali association and 11.8% individualJua Kali workers out of 388 were enrolled in NHIF while 262 (67.5%) were not enrolled in NHIF. Inadequate Knowledge of NHIF benefit and the KShs. 480 upfront NHIF premium payment were the main contributing factors to non-enrolment of262 (67.5%) of Jua Kali workers. 42.3 % individual Jua Kali and 6.1 % members of association with a monthly income less than KShs. 9,000 did not enrol in NHIF. To enhance more enrolment of Jua Kali workers, the study recommends that NHIF should design strategies that target the younger, low income and Jua Kali workers with low level of education with key information on health insurance benefits and the benefits of enrollment in NHIF , establish satellite pay¬ment offices within Jua Kali working zones to bring services closer to them, apply KShs. 160 per month instead of KShs. 480 and enhance networking and engage Jua Kali association as strategic partners for the purpose of motivating Jua Kali workers enrollment.