title: Can incentives reduce the barriers to use of antenatal care and delivery services in Kenya?: Results of a qualitative inquiry.
abstract: A qualitative inquiry was used to assess if incentives consisting of a hygiene kit, protein-fortified flour, and delivery kit reduced barriers to antenatal care and delivery services in Nyanza Province, Kenya. We conducted 40 interviews (baseline: five nurses, six mothers, one focus group of five mothers; follow-up: nine nurses, 19 mothers) to assess perceptions of these services. Mothers and nurses identified poor quality of care, fear of HIV diagnosis and stigma, inadequate transport, and cost of care as barriers. Nurses believed incentives encouraged women to use services; mothers described wanting good birth outcomes as their motivation. While barriers to care did not change during the study, incentives may have increased service use. These findings suggest that structural improvements-upgraded infrastructure, adequate staffing, improved treatment of women by nurses, low or no-cost services, and provision of transport-could increase satisfaction with and use of services, improving maternal and infant health.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Fleming
authors.forename: Joanna
authors.initials: J
authors.lastname: Gaines
authors.forename: Katherine
authors.initials: K
authors.lastname: O'Connor
authors.forename: Judith
authors.initials: J
authors.lastname: Ogutu
authors.forename: Nancy
authors.initials: N
authors.lastname: Atieno
authors.forename: Salimah
authors.initials: S
authors.lastname: Atieno
authors.forename: Mary L
authors.initials: ML
authors.lastname: Kamb
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
mesh_terms: D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D009042:Motivation; D009726:Nurses / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards; D013587:Syphilis / Q000175:diagnosis; D014186:Transportation; D014230:Triazoles
chemical_list: D014230:Triazoles; C081017:4-chlorophenyl-2-(1H-1,2,4-triazol-yl)cycloheptanol