Evaluating the impact of social franchising on family planning use in KenyaReport as inadecuate




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Journal of Health, Population and Nutrition

, 35:19

First Online: 18 June 2016Received: 29 March 2016Accepted: 10 June 2016DOI: 10.1186-s41043-016-0056-y

Cite this article as: Chakraborty, N.M., Mbondo, M. & Wanderi, J. J Health Popul Nutr 2016 35: 19. doi:10.1186-s41043-016-0056-y

Abstract

BackgroundIn Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya’s largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning FP, and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector.

MethodsA quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted.

ResultsOverall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method LAPM. There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users adj. OR = 1.49, p = 0.015. Further, women aged 18–24 and 41–49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas.

ConclusionsThis study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

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Author: Nirali M. Chakraborty - Mwende Mbondo - Joyce Wanderi

Source: https://link.springer.com/







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