Case study 1: Burden of seeking healthcare

Evaline lives with her husband and 10 other family members including children, grandchildren and nieces. She and her husband suffer from chronic conditions. She has hypertension and painful arthritis on her knees. Her husband suffers from diabetes and has a chronic kidney condition. He has a wound on his leg that is taking long to heal because of his diabetes. Other health condition in the household include asthma, malaria, eye problems, pneumonia, and suspected mental illness. Evaline admits that she has used traditional medicine for her hypertension but also continues with her medicine. Despite having health insurance, the household spends a lot of money on seeking healthcare especially for her husband who depends on drugs for the kidney condition “We use a lot of money and that’s why we are just here at home now, because we don’t have the money to go to hospital. When you go to hospital they want a lot of money. For example, if you say that you will go to [private health facility X] they want almost 4000 shillings, so when we have to, we just go to [public facility Y] even if you don’t get well, God will help you Her firewood selling business doesn’t give them enough income and her husband cannot work because of his condition. On average, her hypertension medication costs Ksh. 600 monthly while her husband’s drugs cost Ksh. 3,000 monthly. The last time he was admitted, their son paid the bill of approximately ksh. 20,000 through fundraising “You see when we are seeking treatment we need to give out money and that’s where most of the money goes. Sometimes you have nothing, you are just there. Will you tell your child to take you to hospital? Sometimes even your child has no money. The child might delay in taking you to hospital until the illness goes away on its own… If you are unable to go to hospital, what will you do? It will just go away on its own.” (IDI_B_Active_01)