03. Journals

3,111 items available

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https://hdl.handle.net/10986/2210

These are journal articles published in World Bank journals as well as externally by World Bank authors.

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Now showing 1 - 7 of 7

Disrupted Service Delivery? The Impact of Conflict on Antenatal Care Quality in Kenya
(Frontiers Media, 2021-02-28) Wong, Kerry L.M.; Chukwuma, Adanna; Ekhator-Mobayode, Uche Eseosa
African countries facing conflict have higher levels of maternal mortality. Understanding the gaps in the utilization of high-quality maternal health care is essential to improving maternal survival in these states. Few studies have estimated the impact of conflict on the quality of health care. In this study, we estimated the impact of conflict on the quality of health care in Kenya, a country with multiple overlapping conflicts and significant disparities in maternal survival. Our study demonstrates the importance of designing maternal health policy based on the context-specific evidence on the mechanisms through which conflict affects health care. In Kenya, deterioration of equipment and infrastructure does not appear to be the main mechanism through which conflict has affected ANC quality. Further research should focus on better understanding the determinants of the gaps in process quality in conflict-affected settings, including provider motivation, competence, and incentives.
Accessibility Across Transport Modes and Residential Developments in Nairobi
(Elsevier, 2019-01) Campbell, Kayleigh B.; Rising, James A.; Klopp, Jacqueline M.; Mbilo, Jacinta Mwikali
A key goal of urban transportation planning is to provide people with access to a greater number of opportunities for interaction with people and places. Measures of accessibility are gaining attention globally for use in planning, yet few studies measure accessibility in cities in low-income countries, and even fewer incorporate semi-formal bus systems, also called paratransit. Drawing on rich datasets available for Nairobi, Kenya this analysis quantifies place-based accessibility for walking, paratransit, and driving using three different measures: a mobility measure quantifying how many other locations in Nairobi can be reached in 60 min, a contour measure quantifying the number of health facilities that can be reached in 60 min, and a gravity measure quantifying the number of health facilities weighted by a time-decay function. Health facilities are used because they are an essential service that people need physical access to and as a representation of the spatial distribution of activities more broadly. The findings show that place-based accessibility is highest for driving, then paratransit, then walking, and that there are high levels of access to health facilities near the Central Business District (CBD) for all modes. Additionally, paratransit accessibility is comparatively better in the contour and gravity measures, which may mean that paratransit is efficiently providing access based on the spatial distribution of services. The contour measure results are also compared across different residential levels, which are grouped based on neighborhood characteristics and ordered by income. Counterintuitively, the wealthiest areas have very low levels of place-based accessibility for all modes, while poor areas have comparatively better walking access to health facilities. Interestingly, the medium low residential level, characterized in part by tenement apartment buildings, has significantly higher accessibility than other residential types. One way to reduce inequality in access across income groups is to increase spatial accessibility for the modes used by low- and middle-income households, for example with policies that prioritize public transport and non-motorized travel, integrate paratransit with land use development, and provide safe, efficient, and affordable options.
Kenya National Hospital Insurance Fund Reforms: Implications and Lessons for Universal Health Coverage
(Taylor and Francis, 2018-11-06) Barasa, Edwine; Rogo, Khama; Mwaura, Njeri; Chuma, Jane
This article identifies and describes the reforms undertaken by the National Hospital Insurance Fund (NHIF) and examines their implications for Kenya’s quest to achieve universal health coverage (UHC). We undertook a review of published and grey literature to identify key reforms that had been implemented by the NHIF since 2010. We examined the reforms undertaken by the NHIF using a health financing evaluation framework that considers the feasibility, equity, efficiency, and sustainability of health financing mechanisms. We found the following NHIF reforms: (1) the introduction of the Civil Servants Scheme (CSS), (2) the introduction of a stepwise quality improvement system, (3) the health insurance subsidy for the poor (HISP), (4) revision of monthly contribution rates and expansion of the benefit package, and (5) the upward revision of provider reimbursement rates. Though there are improvements in several areas, these reforms raise equity, efficiency, feasibility, and sustainability concerns. The article concludes that though NHIF reforms in Kenya are well intentioned and there has been improvement in several areas, design attributes could compromise the extent to which they achieve their intended goal of providing universal financing risk protection to the Kenyan population.
Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
(Taylor and Francis, 2018-03-08) Prakash, Ravi; Bhattacharjee, Parinita; Blanchard, Andrea; Musyoki, Helgar; Anthony, John; Kimani, Joshua; Gakii, Gloria; Sirengo, Martin; Muraguri, Nicholas; Mziray, Elizabeth; Kasonde, Lombe; Blanchard, James; Isac, Shajy; Moses, Stephen
While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW program exposure levels and behavioral outcomes including condom use, sexually transmitted infection (STI)-treatment, and empowerment measures like disclosure of self-identity and violence reporting. We categorized program exposure levels as none, moderate and intensive. Multivariate logistic regression was used for analysis. Overall, 35% of the FSWs were not exposed to any HIV prevention program, whereas about 24% had moderate and 41% had intensive exposure. FSWs having intensive program exposure had a higher likelihood of using condoms consistently with occasional clients (AOR: 1.57; 95% CI: 1.08–2.31) and seeking treatment for STIs (AOR: 3.37; 95% CI: 1.63–7.02) compared to FSWs with no or moderate exposure. Intensive program exposure was also associated with higher self-disclosure of sex-work identity (AOR: 1.63; 95% CI: 1.19–2.24), reporting of violence to police (AOR: 2.45; 95% CI: 1.03–5.84), and negotiation of condom use at last sex when the client was under the influence of alcohol (AOR: 1.63; 95% CI: 0.94–2.82). Although HIV prevention programs in Kenya have been underway for over a decade, program efforts were largely focused on saturating the coverage (intervention breadth). Strategies should now focus on ensuring improved quality of contacts through intensified program exposure (intervention depth) to enhance gains in behavioral change among FSWs and preventing the burden of HIV infection among them.
Variation in Quality of Primary-Care Services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania
(World Health Organization, 2017-06) Kruk, Margaret E.; Chukwuma, Adanna; Mbaruku, Godfrey; Leslie, Hannah H.
Although substantial progress has been made in reducing child and maternal deaths in the past 15 years, many women and children in low- and middle-income countries continue to die of avertable causes. To stimulate a concerted effort to narrow the gap between rich and poor countries, the United Nation’s sustainable development goals (SDGs) include new targets to reduce maternal mortality to less than 70 per 100 000 live births and to reduce deaths of children younger than five years to 25 per 1000 live births by 2030. In this paper, we analyse the variation in the quality of processes of care in health facilities in seven countries in subSaharan Africa for two primary-care services: (i) antenatal care and (ii) care of sick children, using observations of clinical care, a gold standard measure of process quality. The results will inform policy-makers about current performance and provide a starting point for a broader discussion of quality measurement in the SDG era.
Diet Quality, Child Health, and Food Policies in Developing Countries
(Oxford University Press on behalf of the World Bank, 2015-08) Bhargava, Alok
Although the importance of diet quality for improving child health is widely recognized, the roles of environmental factors and the absorption of nutrients for children's physical growth and morbidity have not been adequately integrated into a policy framework. Moreover, nutrient intakes gradually affect child health, so it is helpful to use alternative tools to evaluate short-term interventions versus long-term food policies. This article emphasizes the role of diet quality reflected in the intake of nutrients such as protein, calcium, and iron for children's physical growth. Vitamins A and C are important for reducing morbidity. Children's growth and morbidity affect their cognitive development, which is critical for the future supply of skilled labor and economic growth. Evidence on these issues from countries such as Bangladesh, India, Kenya, the Philippines, and Tanzania is summarized. The supply of nutritious foods is appraised from the viewpoint of improving diet quality. Finally, the roles of educational campaigns and indirect taxes on unhealthy processed foods consumed by the affluent in developing countries are discussed.
Evaluation of the Impact of a Mobile Health System on Adherence to Antenatal and Postnatal Care and Prevention of Mother-to-Child Transmission of HIV Programs in Kenya
(BioMed Central, 2015-02-07) Mushamiri, Ivy; Luo, Chibulu; Iiams-Hauser, Casey; Amor, Yanis Ben
The Millennium Villages Project (MVP) implemented in Western Kenya a mobile Health tool that uses text messages to coordinate Community Health Worker (CHW) activities around antenatal care (ANC) and Prevention of Mother-to-Child Transmission of HIV (PMTCT), named the ANC/PMTCT Adherence System (APAS). End-user changes in health-seeking behavior in ANC and postnatal care (PNC) were investigated following registration of 800 women into APAS. These investigations employed interviews of pregnant women or new mothers (n = 67) and CHWs (n = 20). Ordinal logistic regressions and exact binomial tests were used in the routine data analyses (n = 650, health registers). All CHWs interviewed agreed that APAS helped them track pregnant woman efficiently, compared to paper-based tracking forms. Women registered in APAS reported that CHWs reminded them of appointments more regularly than before its inception. The APAS also greatly increased the likelihood of women making the 6 recommended post-delivery baby follow-ups.