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Many low income earners rely on meagre out-of-pocket payments for health expenditure leading of indebtedness. This study assessed the reasons for indebtedness a rising from medical costs by Kibera slum dwellers in Nairobi, Kenya. It was a crosssectional study; households were systematically sampled from one randomly selected village (Makina) out of the 12 villages within Kibera slum. A semi-structured, questionnaire was used to gather information on medical expenses incurred by household members and socio-demographic and social economic characteristics. Univariate logistic regression was used to test the associations between indebtedness and social-demographic and social-economic characteristics at a significance level of p ≤ 0.05. A total of 166 households were interviewed. About a quarter (n=39, 23.5%) were indebted from health care expenses. Result of logistic regression returned education, marital status and occupation as significant factors (P ≤ 0.05.). Respectively, study participants with primary and post primary education were 3.5 (95% CI, 1.215, 9.906) P=0.020 and 1.1 (95% CI, 0.435, 3.026) P=0.782 times more likely to be indebted in healthcare compared to those without formal education. Study respondents who were unmarried and separated were each 78% (95% CI, 0.090, 0.515) P=0.001 and 78% (95% CI, 0.083, 0.599) P=0.003, less likely to be indebted in health care compared to those who were married. Respectively, civil servants and casual workers on one hand and small scale business on the other were 2.8 (95% CI, 1.225, 6.286) P=0.014 and 1.2 (95% CI, 0.451, 3.338) P=0.688 times more likely to have debts in the health care as compared to those who were house wives/unemployed. The level of indebtedness was 23.5% among formally educated, married and employed slum dwellers. This finding is counterintuitive as these categories of people have a higher socio economic status relative to those without formal education, not living with a spouse and unemployed. Further studies are needed to authenticate these cross-sectional findings.

Correlates of Slum Household Indebtedness to Medical Care Costs: A Case of Kibera Slums Nairobi, Kenya