Demand for reproductive health vouchers and utilization: a case study of output based approach in Kilifi Kenya

Abstract

Demand side financing initiatives are different forms of financing health services that aim to minimize financial obstacles to accessing health care and also decrease inequities by ensuring that services are made affordable to poor and underserved populations through provision of subsidies. . The voucher system is based on the basic demand theory of economics and seeks to aid in improving health outcomes. Voucher programs are designed to provide patients with the economic power to demand for health care of high quality, to enable high-risk or low-income individuals be able to access acute services, to amplify the rates of consumption of the general population, and to manage unit costs. The voucher program has been implemented in Kenya since the year 2006 and was launched in Kilifi in the year 2011. Despite the fact that many vouchers are purchased, a number of women fail to use them to access services in these accredited facilities. This study seeks to establish why this trend has been observed particularly in the county of Kilifi and the factors that contribute to low utilization of the vouchers. The objective of the research was to come up with a detailed analysis of how demand and utilization of RH-OBA vouchers is shaped by individual characteristics and those of the household. The study used both secondary and primary data. Analysis of the data was done using logistic regression to measure the relationship between the dependent variable and the predictor variables. The statistical test of significance for the regression coefficients (β’s) was done using the Wald chi-square test. The variables used were age, education, occupation, marital status and number of births. Key findings indicate that no education, primary education and unemployment were found to have a relationship with demand for RH-OBA health vouchers. The findings from the utilization model suggested that only age, age squared, single and married were found to be statistically significant. Further studies and analysis may be needed to establish other factors that affect the decision to utilize health services other than the variables analysed. Having a voucher or insurance card may not guarantee improved utilization of health care and therefore other efforts such as investing in infrastructure, human resources, commodities and medical supplies, need to be put in place to ensure that people are able to access and utilize services of high quality. This will encourage service utilization at the facility level.