Communication Factors Influencing Awareness of Government Medical Schemes among Informal Sector Workers: A Study of Kibera Sub-County, Nairobi County, Kenya
Year: 2026
Type: article
Study design: Observational Study
Abstract: Purpose: This study examined communication factors influencing awareness of government medical schemes in Kenya among informal sector workers in Kibera Sub-County, Nairobi County. Methodology: The study utilized an explanatory sequential mixed-methods design. The target population comprised urban informal sector workers, from which a sample of 130 respondents was drawn for a quantitative survey, complemented by 12 purposively selected Key Informant Interviews (KIIs) and content analysis of 50 communication artifacts. Quantitative data were processed using SPSS Version 28 to generate descriptive statistics and inferential tests. Findings: The findings highlighted that while 95.4% of respondents superficially recognized the scheme's existence, there was a functional awareness deficit: 31.5% were unable to identify basic benefits, and 46.9% associated mandatory contributions with taxation. There was a significant association between technical English-language materials and lower comprehension (chi-square = 34.28, p < .001, Cramer's V = .586), while Sheng-based materials generated superior comprehension. Interpersonal channels generated a five-fold comprehension leverage ratio compared to mass media broadcasting. Inferential analysis revealed a positive correlation (r = .363, p < .001) between message comprehension and institutional trust. Demographic variables showed no protective effect against confusion. The study concluded that awareness and trust deficits within the informal sector are not demographic challenges, but structural institutional communication design failures rooted in bureaucratic messaging, language exclusion, and opaque financial terminology. Unique Contribution to Theory, Practice and Policy: The study validated the Health Belief Model’s construct that awareness without comprehension is a weak cue to action and Social Marketing Theory’s Promotion principle that the effectiveness of the channel and not just the channel reach is key in determining the uptake of government medical schemes in the informal sector. SHA must be flexible in its language policy to include comprehensible Swahili and Sheng to dismantle the cognitive barriers erected by bureaucracy. SHA should scale up Community Health Volunteers (CHV) access to increase understanding of the medical scheme. The SHA Communication department must ensure technical terminology and registration instructions are replaced with plain language so as to transparently address the existing trust deficit. Additionally, campaigns must transition from top-down institutional directives to peer-led advocacy.
DOI: 10.47604/ijcpr.3931
Authors: Grace Wabuko, Eunice Kijana, Margaret Mtange
Institution: Multimedia University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7203776262