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Private health insurance is crucial for healthcare financing, but its uptake remains suboptimal, with many still relying on out-of-pocket expenses. Statistics indicate Kenya's informal sector comprises 83.3% of the population, with only 2% of employees having national hospital insurance and 20% having public health insurance. Therefore, this study investigated effect of strategic decision on uptake of private health insurance services, specifically, the study examined the effect of level of coverage, cost and affordability, network of health providers and quality of services on uptake of private health insurance services in Nairobi City County, Kenya. The study was anchored using the agency theory, dynamic capability theory and expected utility theory. The study embraced descriptive research design. The target population was sixteen private health insurance in Nairobi city county, Kenya. A sample size of eighty was utilized, employing census. Primary data was collected using a semi-structured questionnaire. The response rate was sixty eight percent. Level of coverage, cost and affordability, network of health providers and quality of services had a significant effect on uptake of private health insurance services. The study recommend, insurance providers should continue to offer diverse plans that cater to different needs and income brackets, ensuring that comprehensive coverage options remain accessible to a broad audience. Additionally, insurers should continue to develop and offer flexible payment plans that cater to different income levels. Introducing tiered pricing models, where customers can choose from a range of premium options based on their financial capacity, can make insurance more accessible. Moreover, the insurer should focus on maintaining a strong commitment to service quality and continually refining their offerings, which can build greater trust and satisfaction among customers, leading to increased adoption of private health insurance services.

Under capitation health scheme, a member freely selects a health facility from which to seek health services. There is no restriction of the number of times a member seeks health services from the facility within the contract period. This has affected delivery of health service under capitation contracting. This paper documents a quantitative analysis of the effect of health seeking behaviour on effective delivery of health services. Since human behaviour is assumed to be a natural phenomena, a philosophical view of positivism w?s ?dopted in this research. Accordingly, a scientific approach was used to deduce the influence of health seeking behaviour on the metrics of effectiveness. Out of 1152 health facilities accredited to offer primary healthcare in Kenya, data was collected from a sample of 297 health units using closed ended questionnaires. Logit regression analysis on the data revealed that congestion in out-patient department had a negative effect on quality of health services delivered but a positive effect on accessibility and affordability of the services. Increased frequency of consultation had a negative effect on all the three measures of effectiveness; quality, accessibility and affordability of health service delivery. Corresponding odds ratios were 0.173, 1.105 and 1.295 respectively.

Co-payment is an out-of-pocket payment collected by the service provider from members capitated by a health scheme for the purpose of gatekeeping against the misuse of the services. This paper documents an assessment of the effect of copayment on the effectiveness of health services delivered under the capitation scheme in Kenya. The unit of analysis was the 1152 health facilities capitated by the National Hospital Insurance Fund to provide outpatient primary healthcare in Kenya as of July 2015. logit regression was used to analyze the data collected from a sample of 297 capitated health facilities. The Effectiveness of the delivery of health services was evaluated using three metrics; quality, accessibility, and affordability. The regression model for each of the metrics was constructed in order to examine the effect of copayment on the delivery of services. The results revealed that an increment of one unit on copayment increased the index of delivery of quality, accessible and affordable health services by .073, 4.349 and 79.4 respectively. The optimal amount of copayment is determined from the models using theories of calculus.