Inequality of Opportunity in Maternal Health Among Adolescent in Kenya
Abstract
Maternal health is both a public health and socio-economic burden. Adolescent mothers
face higher maternal mortality and morbidity rates compared to older women in the
reproductive age. Pregnancy complications are the second driving reason for deaths
among 15-19-year-old adolescents globally. Stigma and discrimination are associated
negatively with demand for maternal health care among adolescents and they often lead
to societal rejection of teenage pregnancy contributing to more complications like
suicide, mental illness, unsafe abortion and ultimately death. Like in many nations, the
sustainable development goals (SDG) target 3.8 on achieving universal health coverage
and SDG target 3.1.1 on maternal mortality ratio, has not yet been accomplished for the
greater part of the health service. Kenya is determined at improving maternal health by
decreasing inequalities in adolescent health care through creating access to the
government funded maternity health services. However, access and utilization of this
health services among adolescents is very low due to the inequalities that is beyond
their control. Therefore, this study assessed the degree to which inequalities of
opportunity are associated with access and utilisation of maternal health services among
the adolescents. Three waves of pooled Kenya Demographic Health Survey (KDHS)
data for 2003, 2008/09 and 2014 were used in the study. The study applied the Human
Opportunity Index (HOI) methodology to estimate the coverage rate of this
opportunities that is discounted as a result of the unequal allocations while the shapely
decomposition was used to determine the contribution of each circumstance to the
imbalances. The result coverage rate for ever pregnant, antenatal care, facility delivery
and post-natal care among adolescents are 17.5%, 52.6.%, 70.6% and 59.8%
respectively. The inequality measured by dissimilarity index (D) is lowest among
adolescent facility delivery (11.1%) and highest among ever pregnant (20.24%). At the
same time, opportunities for access to these maternal health opportunities also vary
ranging from 14% for ever pregnant to only to 62.4% for facility delivery. Wealth
Status, education and location were the major contributors to inequalities among this
age group. These finding provides valuable evidence on inequalities of opportunities
in maternal health to support legislation when developing policies to actualize
compensatory measures planned to diminish opportunity gaps. There is also the need
for equitable resource allocation for maternal health services among adolescents to
ensure that such opportunities are not correlated with individual or society’s
background. Moreover, there is need to have a multisectoral approach in addressing
some of the imbalances that contribute to this inequality such as having socio-economic
empowerment programs.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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