Maternal Healthcare Service Utilization and Inequalities Post Devolution of Health Services in Kenya: Evidence from 2014 and 2022 Kenya Demographic and Health Surveys

Stephen Ndambuki, Regional Institute for Population Studies
Bernard Kiprotich, Employee NCPD
Sheikh Mohammed , National Council for Population and Development

This paper analyses maternal healthcare utilization and inequalities among married women across top 10 counties with highest and lowest maternal mortality ratios in Kenya post devolvement of healthcare services. It utilizes two rounds of Kenya Demographic and Health surveys carried out in 2014 and 2022 to compare trends in utilization of maternal healthcare services (modern contraceptive use, health facility delivery, skilled delivery assistance) and related inequalities. Preliminary findings show improved utilization of the key maternal healthcare service indicators across all the counties over the period. The use of modern contraceptive depicts marginal gains with some counties. However, some counties such as Kirinyaga, Makueni and Mombasa experiencing decline in contraceptive use over the period. The inequalities in the utilization of the services by wealth quintile show mix distributions across counties. The higher proportions of users in the lower quantile in some counties reflect potential improvements in access to primary healthcare as envisioned in the devolvement of health services.