Open AccessLevels and variations in the quality of facility-based antenatal care in Kenya: evidence from the 2010 service provision assessment
Author(s) -
Elizabeth Lee,
Supriya Madhavan,
Sebastian Bauhoff
Publication year - 2016
Publication title -
health policy and planning
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.608
H-Index - 92
eISSN - 1460-2237
pISSN - 0268-1080
DOI - 10.1093/heapol/czv132
Subject(s) - operationalization , business , quality (philosophy) , empirical evidence , public economics , service (business) , scale (ratio) , service delivery framework , program evaluation , quality management , marketing , economics , geography , political science , philosophy , cartography , epistemology , public administration
Quality of care is emerging as an important concern for low- and middle-income countries working to expand and improve coverage. However, there is limited systematic, large-scale empirical guidance to inform policy design. Our study operationalized indicators for six dimensions of quality of care that are captured in currently available, standardized Service Provision Assessments. We implemented these measures to assess the levels and heterogeneity of antenatal care in Kenya. Using our indicator mix, we find that performance is low overall and that there is substantial variation across provinces, management authority and facility type. Overall, facilities performed highest in the dimensions of efficiency and acceptability/patient-centeredness, and lowest on effectiveness and accessibility. Public facilities generally performed worse or similarly to private or faith-based facilities. We illustrate how these data and methods can provide readily-available, low-cost decision support for policy.