title: Levels and variations in the quality of facility-based antenatal care in Kenya: evidence from the 2010 service provision assessment.
abstract: Quality of care is emerging as an important concern for low- and middle-income countries working to expand and improve coverage. However, there is limited systematic, large-scale empirical guidance to inform policy design. Our study operationalized indicators for six dimensions of quality of care that are captured in currently available, standardized Service Provision Assessments. We implemented these measures to assess the levels and heterogeneity of antenatal care in Kenya. Using our indicator mix, we find that performance is low overall and that there is substantial variation across provinces, management authority and facility type. Overall, facilities performed highest in the dimensions of efficiency and acceptability/patient-centeredness, and lowest on effectiveness and accessibility. Public facilities generally performed worse or similarly to private or faith-based facilities. We illustrate how these data and methods can provide readily-available, low-cost decision support for policy.
authors.affiliation: University Research Co, LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee
authors.affiliation: U.S. Agency for International Development, 1201 Pennsylvania Ave, NW Suite 315, Washington, DC 20004 and.
authors.forename: Supriya
authors.initials: S
authors.lastname: Madhavan
authors.affiliation: Center for Global Development, 2055 L Street NW, Washington, DC20036, USA sbauhoff@cgdev.org.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bauhoff
mesh_terms: D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006268:Health Facilities / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D017149:Private Sector; D017150:Public Sector; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards*
keywords: Global health; health care facilities; quality of care; variations