Who remains uncovered? Assessing inequalities and determinants of national health insurance enrolment among informal sector workers in Kenya

Our findings suggest that enrollment rates among informal sector workers remain low, and important pro-rich inequalities prevail. Economic factors, education, and prior experience with healthcare services were key drivers of national health insurance enrollment. Further policies are needed to increase enrollment among informal sector workers, including differential premium levels, reliance on expanded targeted subsidies, and enhanced awareness campaigns. Our findings are also applicable to other low-resource settings experiencing conditions similar to those in Kenya as they transition toward national health insurance policies, with the goal of achieving universal health coverage.