IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0171236.html
   My bibliography  Save this article

Poor Quality for Poor Women? Inequities in the Quality of Antenatal and Delivery Care in Kenya

Author

Listed:
  • Jigyasa Sharma
  • Hannah H Leslie
  • Francis Kundu
  • Margaret E Kruk

Abstract

Background: Quality of healthcare is an important determinant of future progress in global health. However, the distributional aspects of quality of care have received inadequate attention. We assessed whether high quality maternal care is equitably distributed by (1) mapping the quality of maternal care in facilities located in poorer versus wealthier areas of Kenya; and (2) comparing the quality of maternal care available to Kenyans in and not in poverty. Methods: We assessed three measures of maternal care quality: facility infrastructure and clinical quality of antenatal care and delivery care, using indicators from the 2010 Kenya Service Provision Assessment (SPA), a standardized facility survey with direct observation of maternal care provision. We calculated poverty of the area served by antenatal or delivery care facilities using the Multidimensional Poverty Index. We used regression analyses and non-parametric tests to assess differences in maternal care quality in facilities located in more and less impoverished areas. We estimated effective coverage with a minimum standard of care for the full population and those in poverty. Results: A total of 564 facilities offering at least one maternal care service were included in this analysis. Quality of maternal care was low, particularly clinical quality of antenatal and delivery care, which averaged 0.52 and 0.58 out of 1 respectively, compared to 0.68 for structural inputs to care. Maternal healthcare quality varied by poverty level: at the facility level, all quality metrics were lowest for the most impoverished areas and increased significantly with greater wealth. Population access to a minimum standard (≥0.75 of 1.00) of quality maternal care was both low and inequitable: only 17% of all women and 8% of impoverished women had access to minimally adequate delivery care. Conclusion: The quality of maternal care is low in Kenya, and care available to the impoverished is significantly worse than that for the better off. To achieve the national targets of maternal and neonatal mortality reduction, policy initiatives need to tackle low quality of care, starting with high-poverty areas.

Suggested Citation

  • Jigyasa Sharma & Hannah H Leslie & Francis Kundu & Margaret E Kruk, 2017. "Poor Quality for Poor Women? Inequities in the Quality of Antenatal and Delivery Care in Kenya," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0171236
    DOI: 10.1371/journal.pone.0171236
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0171236
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171236&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0171236?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7097, eSocialSciences.
    2. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7222, eSocialSciences.
    3. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
    4. Jishnu Das & Jeffrey Hammer, 2014. "Quality of Primary Care in Low-Income Countries: Facts and Economics," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 525-553, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Paul, Sohini & Paul, Sourabh & Gupta, Ashish Kumar & James, K.S., 2022. "Maternal education, health care system and child health: Evidence from India," Social Science & Medicine, Elsevier, vol. 296(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jussi T. S. Heikkila, 2020. "Classifying economics for the common good: Connecting sustainable development goals to JEL codes," Papers 2004.04384, arXiv.org.
    2. Donatella Saccone, 2021. "Can the Covid19 pandemic affect the achievement of the ‘Zero Hunger’ goal? Some preliminary reflections," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1025-1038, September.
    3. Ali, Murad, 2017. "Implementing the 2030 Agenda in Pakistan: the critical role of an enabling environment in the mobilisation of domestic and external resources," IDOS Discussion Papers 14/2017, German Institute of Development and Sustainability (IDOS).
    4. MacFeely Steve, 2017. "Measuring the Sustainable Development Goals: What does it mean for Ireland?," Administration, Sciendo, vol. 65(4), pages 41-71, December.
    5. Kedir Y. Ahmed & Allen G. Ross & Seada M. Hussien & Kingsley E. Agho & Bolajoko O. Olusanya & Felix Akpojene Ogbo, 2023. "Mapping Local Variations and the Determinants of Childhood Stunting in Nigeria," IJERPH, MDPI, vol. 20(4), pages 1-16, February.
    6. Cuenca-García, Eduardo & Sánchez, Angeles & Navarro-Pabsdorf, Margarita, 2019. "Assessing the performance of the least developed countries in terms of the Millennium Development Goals," Evaluation and Program Planning, Elsevier, vol. 72(C), pages 54-66.
    7. Debapriya Bhattacharya & Lumbini Barua & Shusmita Islam, 2018. "Exploring The State of Youth in the SDG Context: How is Bangladesh Doing?," CPD Working Paper 119, Centre for Policy Dialogue (CPD).
    8. Alvaro Mendez & David Patrick Houghton, 2020. "Sustainable Banking: The Role of Multilateral Development Banks as Norm Entrepreneurs," Sustainability, MDPI, vol. 12(3), pages 1-21, January.
    9. Mason-D'Croz, Daniel & Sulser, Timothy B. & Wiebe, Keith & Rosegrant, Mark W. & Lowder, Sarah K. & Nin-Pratt, Alejandro & Willenbockel, Dirk & Robinson, Sherman & Zhu, Tingju & Cenacchi, Nicola & Duns, 2019. "Agricultural investments and hunger in Africa modeling potential contributions to SDG2 – Zero Hunger," World Development, Elsevier, vol. 116(C), pages 38-53.
    10. Klarin Tomislav, 2018. "The Concept of Sustainable Development: From its Beginning to the Contemporary Issues," Zagreb International Review of Economics and Business, Faculty of Economics and Business, University of Zagreb, vol. 21(1), pages 67-94, May.
    11. Aggarwal, Shilpa, 2021. "The long road to health: Healthcare utilization impacts of a road pavement policy in rural India," Journal of Development Economics, Elsevier, vol. 151(C).
    12. Joshua Amo-Adjei & Kofi Aduo-Adjei & Christiana Opoku-Nyamah & Chimaroake Izugbara, 2018. "Analysis of socioeconomic differences in the quality of antenatal services in low and middle-income countries (LMICs)," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-12, February.
    13. Abreha, Solomon K. & Walelign, Solomon Z. & Zereyesus, Yacob A., 2020. "Associations between Women’s Empowerment and Child Health Status in Ethiopia," 2020 Annual Meeting, July 26-28, Kansas City, Missouri 304174, Agricultural and Applied Economics Association.
    14. Paul H. McClelland & Claire T. Kenney & Federico Palacardo & Nicholas L. S. Roberts & Nicholas Luhende & Jason Chua & Jennifer Huang & Priyanka Patel & Leonardo Albertini Sanchez & Won J. Kim & John K, 2022. "Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis," IJERPH, MDPI, vol. 19(7), pages 1-18, April.
    15. Bruno Boidin, 2020. "The social determinants of health in Africa from a political economy perspective: an exploratory contribution," Working Papers hal-02555436, HAL.
    16. Rashidul Alam Mahumud & Khorshed Alam & Andre M N Renzaho & Abdur Razzaque Sarker & Marufa Sultana & Nurnabi Sheikh & Lal B Rawal & Jeff Gow, 2019. "Changes in inequality of childhood morbidity in Bangladesh 1993-2014: A decomposition analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-19, June.
    17. Maria Rosa Trovato & Cheren Cappello, 2022. "Climate Adaptation Heuristic Planning Support System (HPSS): Green-Blue Strategies to Support the Ecological Transition of Historic Centres," Land, MDPI, vol. 11(6), pages 1-40, May.
    18. Mario La Torre & Helen Chiappini (ed.), 2020. "Contemporary Issues in Sustainable Finance," Palgrave Studies in Impact Finance, Palgrave Macmillan, number 978-3-030-40248-8, December.
    19. Alicea Skye Garcia & Thomas Wanner, 2017. "Gender inequality and food security: lessons from the gender-responsive work of the International Food Policy Research Institute and the Bill and Melinda Gates Foundation," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 9(5), pages 1091-1103, October.
    20. Teemu Koskimäki, 2021. "Places to Intervene in a Socio-Ecological System: A Blueprint for Transformational Change," Sustainability, MDPI, vol. 13(16), pages 1-17, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0171236. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.