eHealth Literacy Predicts Knowledge of Social Health Authority (SHA) and Social Health Insurance Fund (SHIF) Among Undergraduate Health Students in Kenya, an Analytical Cross-Sectional Study

Low rates of actively contributing to the Social Health Insurance Fund (SHIF) under Social Health Authority (SHA) could be due to health insurance knowledge inadequacies possibly due to poor eHealth literacy. This study assesses whether eHealth literacy predicts SHA/SHIF knowledge among undergraduate students in health-related courses in Kenya. An analytical cross-sectional online survey was conducted using the eHealth Literacy Scale (eHEALS) and adapted Kaiser Family Foundation quiz to collect data. A total of 207 tertiary education students mainly pursuing six health courses in 21 institutions in Kenya responded to the survey. The median eHealth literacy score was 3.9/5, with about 54% having high eHealth literacy levels (median ≥ 4). About 9.2% of the students had never heard of SHA/SHIF while only 21.7% had high knowledge of SHA/SHIF (median ≥ 4), with the median knowledge score being 3/5. Only high eHealth literacy compared to low eHealth literacy (OR = 6.2, p<0.0001) and pursuing nursing, public health, and other courses compared to pursuing MBChB (OR = 4.9-5.1, p = 0.01-0.03) significantly predicted SHA/SHIF knowledge. Thus, health students in Kenya had modest eHealth literacy levels and SHA/SHIF knowledge. eHealth literacy was a significant predictor of SHA/SHIF knowledge, thus interventions can target it.