title: Determining the effective coverage of maternal and child health services in Kenya, using demographic and health survey data sets: tracking progress towards universal health coverage.
abstract: Effective coverage (EC) is a measure of health systems' performance that combines need, use and quality indicators. This study aimed to assess the extent to which the Kenyan health system provides effective and equitable maternal and child health services, as a means of tracking the country's progress towards universal health coverage.
  
  
  
  The Demographic Health Surveys (2003, 2008-2009 and 2014) and Service Provision Assessment surveys (2004, 2010) were the main sources of data. Indicators of need, use and quality for eight maternal and child health interventions were aggregated across interventions and economic quintiles to compute EC. EC has increased from 26.7% in 2003 to 50.9% in 2014, but remains low for the majority of interventions. There is a reduction in economic inequalities in EC with the highest to lowest wealth quintile ratio decreasing from 2.41 in 2003 to 1.65 in 2014, but maternal health services remain highly inequitable.
  
  
  
  Effective coverage of key maternal and child health services remains low, indicating that individuals are not receiving the maximum possible health gain from existing health services. There is an urgent need to focus on the quality and reach of maternal and child health services in Kenya to achieve the goals of universal health coverage.
authors.affiliation: Health Economics Research Unit, KEMRI - Wellcome Trust Research Programme, Nairobi, Kenya.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Nguhiu
authors.affiliation: Health Economics Research Unit, KEMRI - Wellcome Trust Research Programme, Nairobi, Kenya.|Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Edwine W
authors.initials: EW
authors.lastname: Barasa
authors.affiliation: Health Economics Research Unit, KEMRI - Wellcome Trust Research Programme, Nairobi, Kenya.|The World Bank, Kenya Country Office.
authors.forename: Jane
authors.initials: J
authors.lastname: Chuma
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000592:standards; D005260:Female; D000069576:Health Equity; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services / Q000592:standards; D008875:Middle Aged; D011247:Pregnancy; D012923:Social Class; D012959:Socioeconomic Factors; D019472:Universal Health Insurance; D055815:Young Adult
keywords: Kenia; Kenya; calidad; cobertura efectiva; couverture effective; effective coverage; equidad; equity; maternal and child health; quality; qualité; salud materno-infantil; santé maternelle et infantile; équité