Benefit Incidence Analysis for Maternal Newborn and Child Health Services in Kenya

Abstract

Mother and child health services financing is a key government priority objective in most countries and the delivery of this strategic direction usually lies fundamentally on the distributional issues aimed at addressing the health sector equity objectives geared towards ensuring that the benefits equal the healthcare need of the target population. The health subsidies provided by the governments should therefore be target efficient such that only the population segments in higher need for the subsidies actually receives them. This study sought to address the questions in public policy strategies, such as, how well public resources are spent on healthcare, to assess if the benefits ultimately reach the poorest segment of the population and whether the government expenditure on maternal, newborn and child health services are focused to address the needs of the poor populations to protect them from the financial risks of paying for the services. The goal of this current study was to establish if these benefits from the government subsidies for mother and child health services actually addresses the needs of the intended socio-economic groups in Kenya. Benefit incidence analysis approach was utilized to assess the accrued benefits of the subsidies for providing and utilization of maternal, newborn and child health services by different socio-economic groups in Kenya. The Kenya demographic health survey data (2013/14) and the national health account data (2013/14) were utilized to establish the per capita subsidy of mother and child health services utilization across the population with reference to their different socio-economic levels based on their wealth indices. The study outcome demonstrated inequality in utilization of these services in relation to individuals or households’ income status and the patterns were varied across the wealth quintiles in different areas of residence i.e. rural or urban. The total subsidy was pro-poor however when these results were further examined by looking at benefits received by individual households across the wealth indices, the outcome demonstrated that the wealthier households actually received high proportions of the subsidies than the poor. In urban areas and the private facilities, there were notable inequality in targeting the subsidies to the poor, this demonstrated that more effective focusing of maternal and child health is paramount. The observed pro-rich inequality in maternal child healthcare utilization in this study could be reduced by ensuring social inclusion and eliminating barriers to access to the services by the poor rural women.