Who pays and how much? A cross-sectional study of out-of-pocket payment for modern contraception in Kenya

BMJ Open
Emma RadovichLenka Benova

Abstract

Out-of-pocket (OOP) payment for modern contraception is an understudied component of healthcare financing in countries like Kenya, where wealth gradients in met need have prompted efforts to expand access to free contraception. This study aims to examine whether, among public sector providers, the poor are more likely to receive free contraception and to compare how OOP payment for injectables and implants-two popular methods-differs by public/private provider type and user's sociodemographic characteristics. Secondary analyses of nationally representative, cross-sectional household data from the 2014 Kenya Demographic and Health Survey. Respondents were women of reproductive age (15-49 years). The sample comprised 5717 current modern contraception users, including 2691 injectable and 1073 implant users with non-missing expenditure values. Respondent's self-reported source and payment to obtain their current modern contraceptive method. We used multivariable logistic regression to examine predictors of free public sector contraception and compared average expenditure for injectable and implant. Quintile ratios examined progressivity of non-zero expenditure by wealth. Half of public sector users reported free contraception; this...Continue Reading

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Methods Mentioned

BETA
contraception

Software Mentioned

Stata
SE

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