Discussion Paper No. 190 of 2017 on Inequalities in Health Care Service Delivery in Kenya

Abstract

This study investigated inequalities in health care service delivery using the Service Delivery Indicators (SDI) survey 2012 conducted by KIPPRA on behalf of the Ministry of Health and the World Bank. The objective of this paper is to analyze inequality in health service delivery in Kenya. The study uses service delivery indicators for health inputs which attempt to measure availability of key infrastructure and inputs at the health facilities, as well as measure effort of the health providers. This is also used as proxy for the effort put in by health workers, and it is from this that levels of inequality in service provision are measured using the Gini coefficient. The study found that Kenya does relatively well on availability of key inputs such as infrastructure and medical equipment. On measures of case load by service providers, the results were less positive. Regarding the availability of drugs, there are some important gaps in that only two thirds of tracer drugs are available, and some gaps were identified especially in availability of tracer drugs for mothers and children. The greatest challenge is the provider effort which shows high levels of absenteeism of health care providers. The conclusion is that there is room for improvement in efficiency of spending on human development in the health system in Kenya. Shortage of medicines, uneven distribution of health services, and low availability of equipment, as well as lack of adequate guidelines must all be taken into account as part of basic service management. The study recommends that improvements in service delivery in the health sector should be accelerated through focused investments and coordinated actions that strengthen health systems and increase equitable access to effective health care.