The Association Between Free Maternity Services and Facility Delivery Use: Evidence From Kenya
Thomas, Adam T
In most developing countries, delivering at a health facility plays a vital role in reducing maternal and neonatal mortality. In 2013, Kenya implemented a policy that abolished user fees associated with maternity services at all public health facilities. This paper examines the change, after the policy’s implementation, in the proportion of births that occurred at health facilities (i.e., the proportion of facility deliveries) by employing a difference-in-differences approach. I identify the policy’s influence by comparing the difference in the change in the proportion of facility deliveries between two different sets of treatment and control groups. I find the proportion of facility deliveries increased 7 percentage points more among births to mothers who did not complete secondary education, compared to births to mothers who completed secondary education. However, I observe no statistical difference between the increase in the proportion of facility deliveries among births to mothers from poor households versus among births to mothers from non-poor households. Therefore, this study provides only suggestive evidence that Kenya’s 2013 free maternity service policy has increased the proportion of facility deliveries.
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