Evaluating the impact of social franchising on family planning use in Kenya
Identifieur interne : 001072 ( Main/Exploration ); précédent : 001071; suivant : 001073Evaluating the impact of social franchising on family planning use in Kenya
Auteurs : Nirali M. Chakraborty [États-Unis] ; Mwende Mbondo [Kenya] ; Joyce Wanderi [Kenya]Source :
- Journal of Health, Population, and Nutrition [ 1606-0997 ] ; 2016.
Abstract
In 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.
A 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.
Overall 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,
This 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.
Url:
DOI: 10.1186/s41043-016-0056-y
PubMed: 27316700
PubMed Central: 5025970
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Evaluating the impact of social franchising on family planning use in Kenya</title><author><name sortKey="Chakraborty, Nirali M" sort="Chakraborty, Nirali M" uniqKey="Chakraborty N" first="Nirali M." last="Chakraborty">Nirali M. Chakraborty</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Metrics for Management, Baltimore, MD USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Metrics for Management, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Mbondo, Mwende" sort="Mbondo, Mwende" uniqKey="Mbondo M" first="Mwende" last="Mbondo">Mwende Mbondo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Wanderi, Joyce" sort="Wanderi, Joyce" uniqKey="Wanderi J" first="Joyce" last="Wanderi">Joyce Wanderi</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Population Services Kenya, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Population Services Kenya, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27316700</idno><idno type="pmc">5025970</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025970</idno><idno type="RBID">PMC:5025970</idno><idno type="doi">10.1186/s41043-016-0056-y</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000910</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000910</idno><idno type="wicri:Area/Pmc/Curation">000909</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000909</idno><idno type="wicri:Area/Pmc/Checkpoint">000742</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000742</idno><idno type="wicri:Area/Ncbi/Merge">003837</idno><idno type="wicri:Area/Ncbi/Curation">003837</idno><idno type="wicri:Area/Ncbi/Checkpoint">003837</idno><idno type="wicri:doubleKey">1606-0997:2016:Chakraborty N:evaluating:the:impact</idno><idno type="wicri:Area/Main/Merge">001072</idno><idno type="wicri:Area/Main/Curation">001072</idno><idno type="wicri:Area/Main/Exploration">001072</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Evaluating the impact of social franchising on family planning use in Kenya</title><author><name sortKey="Chakraborty, Nirali M" sort="Chakraborty, Nirali M" uniqKey="Chakraborty N" first="Nirali M." last="Chakraborty">Nirali M. Chakraborty</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Metrics for Management, Baltimore, MD USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Metrics for Management, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Mbondo, Mwende" sort="Mbondo, Mwende" uniqKey="Mbondo M" first="Mwende" last="Mbondo">Mwende Mbondo</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Wanderi, Joyce" sort="Wanderi, Joyce" uniqKey="Wanderi J" first="Joyce" last="Wanderi">Joyce Wanderi</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Population Services Kenya, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Population Services Kenya, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Health, Population, and Nutrition</title><idno type="ISSN">1606-0997</idno><idno type="eISSN">2072-1315</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>In 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.</p></sec><sec><title>Methods</title><p>A 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.</p></sec><sec><title>Results</title><p>Overall 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, <italic>p</italic> = 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.</p></sec><sec><title>Conclusions</title><p>This 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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hanson, K" uniqKey="Hanson K">K Hanson</name></author><author><name sortKey="Berman, P" uniqKey="Berman P">P Berman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berman, P" uniqKey="Berman P">P Berman</name></author><author><name sortKey="Rose, L" uniqKey="Rose L">L Rose</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wang, W" uniqKey="Wang W">W Wang</name></author><author><name sortKey="Sulzbach, S" uniqKey="Sulzbach S">S Sulzbach</name></author><author><name sortKey="De, S" uniqKey="De S">S De</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bustreo, F" uniqKey="Bustreo F">F 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Policar</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>États-Unis</li></country><region><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Chakraborty, Nirali M" sort="Chakraborty, Nirali M" uniqKey="Chakraborty N" first="Nirali M." last="Chakraborty">Nirali M. Chakraborty</name></region></country><country name="Kenya"><noRegion><name sortKey="Mbondo, Mwende" sort="Mbondo, Mwende" uniqKey="Mbondo M" first="Mwende" last="Mbondo">Mwende Mbondo</name></noRegion><name sortKey="Wanderi, Joyce" sort="Wanderi, Joyce" uniqKey="Wanderi J" first="Joyce" last="Wanderi">Joyce Wanderi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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