Perceived quality of and access to care among poor urban women in Kenya and their utilization of delivery care

Harnessing the potential of private clinics

Datos Bibliográficos

ID11490993
AutoresJean‐christophe Fotso (African Population and Health Research Center, autor de correspondencia), J C Fotso, Carol Mukiira (0000-0002-2880-3652, African Population and Health Research Center)
Año2012
Volumen27
Número6
Páginas505-515
Fecha de publicación2012-09-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czr074
PMID22080515
OpenAlexW2110902709
IdiomaEN
Citas recibidas19
Referencias citadas29

This paper uses data from a maternal health study carried out in 2006 in two slums of Nairobi, Kenya, to: describe perceptions of access to and quality of care among women living in informal settlements of Nairobi, Kenya; quantify the effects of women's perceived quality of, and access to, care on the utilization of delivery services; and draw policy implications regarding the delivery of maternal health services to the urban poor. Based on the results of the facility survey, all health facilities were classified as 'appropriate' or 'inappropriate'. The research was based on the premise that despite the poor quality of these maternal health facilities, their responsiveness to the socio-cultural and economic sensitivities of women would result in good perceptions and higher utilization by women. Our results show a pattern of women's good perceptions in terms of access to, and quality of, health care provided by the privately owned, sub-standard and often unlicensed clinics and maternity homes located within their communities. In the multivariate model, the association between women's perceptions of access to and quality of care, and delivery at these 'inappropriate' facilities remained strong, graded and in the expected direction. Women from the study area are seldom able to reach not-for-profit private providers of maternal health care services like missionary and non-governmental organization (NGO) clinics and hospitals. Against the backdrop of challenges faced by the public sector in health care provision, we recommend that the government should harness the potential of private clinics operating in urban, resource-deprived settings. First, the government should regulate private health facilities operating in urban slum settlements to ensure that the services they offer meet the acceptable minimum standards of obstetric care. Second, 'good' facilities should be given technical support and supplied with drugs and equipment.

Business · Economic growth · Economics · Environmental health · Government (linguistics) · Health care · Health facility · Health services · Population · Private sector · Public health · Quality (philosophy) · Socioeconomics · Global Maternal and Child Health · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing