Skip to main content
Kent Academic Repository

Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data

Oyugi, Boniface, Nizalova, Olena, Kendall, Sally, Peckham, Stephen (2023) Does a free maternity policy in Kenya work? Impact and cost–benefit consideration based on demographic health survey data. The European Journal of Health Economics, . (doi:10.1007/s10198-023-01575-w) (KAR id:100073)

Abstract

This paper evaluates the overall effect of the Kenyan free maternity policy (FMP) on the main outcomes (early neonatal and neonatal deaths) and intermediate outcomes (delivery through Caesarean Section (CS), skilled birth attendance (SBA), birth in a public hospital and low birth weight (LBW)) using the 2014 Demographic Health Survey. We applied the difference-in-difference (DID) approach to compare births (to the same mothers) happening before and after the start of the policy (June 2013) and a limited cost–benefit analysis (CBA) to assess the net social benefit of the FMP. The probabilities of birth resulting in early neonatal and neonatal mortality are significantly reduced by 17–21% and 19–20%, respectively, after the FMP introduction. The probability of birth happening through CS reduced by 1.7% after implementing the FMP, while that of LBW birth is increased by 3.7% though not statistically significant. SBA and birth in a public facility did not moderate the policy’s effects on early neonatal mortality, neonatal mortality, and delivery through CS. They were not significant determinants of the policy effects on the outcomes. There is a significant causal impact of the FMP in reducing the probability of early neonatal and neonatal mortality, but not the delivery through CS. The FMP cost-to-benefit ratio was 21.22, and there were on average 4015 fewer neonatal deaths in 2013/2014 due to the FMP. The net benefits are higher than the costs; thus, there is a need to expand and sustainably fund the FMP to avert more neonatal deaths potentially.

Item Type: Article
DOI/Identification number: 10.1007/s10198-023-01575-w
Subjects: H Social Sciences
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Personal Social Services Research Unit
Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Funders: Commonwealth Scholarship Commission (https://ror.org/051x4wh35)
Depositing User: Boniface Oyugi
Date Deposited: 16 Feb 2023 08:39 UTC
Last Modified: 04 Mar 2024 17:06 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/100073 (The current URI for this page, for reference purposes)

University of Kent Author Information

  • Depositors only (login required):

Total unique views for this document in KAR since July 2020. For more details click on the image.