Journal article
Increase in facility-based deliveries associated with a maternal health voucher programme in informal settlements in Nairobi, Kenya
Health policy and planning, v 28(2)
01 Mar 2013
PMID: 22437506
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To measure whether there was an association between the introduction of an output-based voucher programme and the odds of a facility-based delivery in two Nairobi informal settlements.
Nairobi Urban Health and Demographic Surveillance System (NUHDSS) and two cross-sectional household surveys in Korogocho and Viwandani informal settlements in 2004-05 and 2006-08.
Odds of facility-based delivery were estimated before and after introduction of an output-based voucher. Supporting NUHDSS data were used to determine whether any trend in maternal health care was coincident with immunizations, a non-voucher outpatient service. As part of NUHDSS, households in Korogocho and Viwandani reported place of delivery and the presence of a skilled birth attendant (2003-10) and vaccination coverage (2003-09). A detailed maternal and child health (MCH) tool was added to NUHDSS (September 2006-10). Prospective enrolment in NUHDSS-MCH was conditional on having a newborn after September 2006. In addition to recording mother's place of delivery, NUHDSS-MCH recorded the use of the voucher.
There were significantly greater odds of a facility-based delivery among respondents during the voucher programme compared with similar respondents prior to voucher launch. Testing whether unrelated outpatient care also increased, a falsification exercise found no significant increase in immunizations for children 12-23 months of age in the same period. Although the proportion completing any antenatal care (ANC) visit remained above 95% of all reported pregnancies and there was a significant increase in facility-based deliveries, the proportion of women completing 4+ ANC visits was significantly lower during the voucher programme.
A positive association was observed between vouchers and facility-based deliveries in Nairobi. Although there is a need for higher quality evidence and validation in future studies, this statistically significant and policy relevant finding suggests that increases in facility-based deliveries can be achieved through output-based finance models that target subsidies to underserved populations.
Metrics
Details
- Title
- Increase in facility-based deliveries associated with a maternal health voucher programme in informal settlements in Nairobi, Kenya
- Creators
- Ben Bellows - Population Council, Ralph Bunche Rd, General Accident House, PO Box 17643-00500, Nairobi, Kenya. bbellows@popcouncil.orgCatherine Kyobutungi - African Population and Health Research CenterMartin Kavao Mutua - African Population and Health Research CenterCharlotte Warren - African Population and Health Research CenterAlex Ezeh - African Population and Health Research Center
- Publication Details
- Health policy and planning, v 28(2)
- Publisher
- Oxford University Press
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:000315631600003
- Scopus ID
- 2-s2.0-84874914607
- Other Identifier
- 991020531860204721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services