Supply induced demand for Caesarean section in urban Kenya
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Over the years, Kenya has witnessed a significant change in public and private attitudes towards normal and caesarean deliveries at health facilities. In both rural and urban settings, pursuit of safe deliveries is the key objective of providers and families. Over the last decade, Kenya has seen an increase in the numbers of women delivering through the caesarean section. This large increase in demand for caesarean births has raised concern among policy makers as to whether this number is based on need or is due to supply inducement. This study examines whether there exists supply-induced demand for caesarean deliveries in urban areas. The study uses cross sectional data from Kenya Service Provision Assessment Survey (KSP A) of 2004 to estimate demand for caesarean section. Binary response probit model was used for estimation. Catchment area, length of labor and location of facility were found to affect the probability of a caesarean delivery being performed. Similarly.Tacility type, women in active labor upon admission, and the number of obstetricians or gynecologists influence the probability of a caesarean birth. There is a negative correlation between demand for caesarean births in urban areas and number of obstetricians. In particularly, an increase in the number of obstetricians and gynecologists is negatively associated with probability of a caesarean delivery. This is interpreted as evidence of negative supply inducement of demand for caesarean births.