* Corresponding author: Kenneth Saikwo Sisimwo Kenya Methodist University, Kenya. Copyright © 2022 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Willingness to renew national hospital insurance fund among voluntary scheme members in Kajiado County-Kenya Kenneth Saikwo Sisimwo 1, * , Kezia Muthoni Njoroge 1 , Musa Oluoch Ong’ombe 1 and Duncan Ndombi Shikuku 2 1 Kenya Methodist University, Department of public health, Human Nutrition and Dietetics. School of medicine and health sciences, Kenya. 2 Liverpool School of Tropical Medicine, Department of International Health, Nairobi, Kenya. International Journal of Science and Research Archive, 2022, 07(01), 443–455 Publication history: Received on 02 August 2022; revised on 14 September 2022; accepted on 16 September 2022 Article DOI: https://doi.org/10.30574/ijsra.2022.7.1.0187 Abstract Objective: This study established determinants for readiness to renew the NHIF (national hospital Insurance fund) among informal sector national scheme members in Kenya for universal health coverage (UHC). Methods: This was a cross sectional survey on 394 purposively sampled national health insurance members in Kajiado County. Data was collected through questionnaires rated on a 5-point Likert scale. Binary logistic regression was used to establish the significant determinants associated with the willingness to renew the insurance covers. P-values of less than 0.05 were considered statistically significant. Results: Majority of the participants were male (n=266, 67.5%), over 36 years of age (n=330, 83.7%), married (n=200, 50.8%) and lived in large households of over 3 people (n=358, 90.9%). Overall, respondents showed high willingness to continue paying the insurance premiums and renew their insurance covers for health services (Median: 3.86, IQR 0.75). Controlling for all factors, married (AOR 15.6, 2.3-106.4), large household sizes with more than 3 people, low household income per month (less than KSh. 5000), awareness of NHIF fund services (AOR 13.2, 3.1-55.5), service provider factors (AOR 109, 14.8-803.8) and adverse selection on willingness to renew (AOR 0.043, 0.009-0.202) were significant determinants of willingness to renew the insurance cover (p<0.05). Conclusion: Individual factors - married, belonging to larger household, and lower income group, awareness of NHIF services and system/external factors - service provider’s factors and adverse selection on the other hand influenced willingness to renew insurance covers. There is need to increase the community’s awareness on the health insurance risk-benefits through member education and improve access to quality health services in the health facilities to enhance renewal of the NHIF covers by members. Keywords: Health insurance; Universal health coverage (UHC); Informal sector; Health financing; Kenya 1. Introduction Health systems are weak across many parts of advanced economies and emerging Countries in the world. In their quest to achieve states’ global health agenda, such as the sustainable development goal 3. World health organization[1] established “a common framework of action for strengthening health systems made up of the six building blocks including: service delivery, human resources for health , information, medical products, vaccines and technologies;