Population Dynamics & Reproductive Health

Family Planning, Fertility and Population Growth

Progress towards goals 4 (reducing child mortality) and 5 (improving maternal health) of the millennium development goals (MDGs) has been generally slow in sub-Saharan Africa.  To meet these and other MDGs, sub-Saharan Africa’s best hope remains its vast and untapped Human Capital. Yet, about 4 million infants and children continue to die annually from preventable causes, whilst unchecked unintended pregnancy increasingly contributes to unsafe abortion and consequently poor maternal health outcomes. Emerging evidence asserts that the disparity in key family planning and sexual reproductive health indicators is widening, making it clear that our Human Capital has been and is under threat. We need to focus our efforts toward providing robust scientific evidence to guide crucial policy generation and implementation to curb the needless hemorrhage. In doing this we would not only have a fighting chance at meeting the MDGs but we would also have saved and positively impacted countless lives.

Current Project

Pregnant woman 2

Assessing the cost-effectiveness of Free Maternal Care in Kenya

Program: Population Dynamics & Reproductive Health

Kenya’s maternal mortality rate (MMR) remained high over the last two decades, despite efforts to achieve a 75% drop by 2015 as part of attempts to achieve the Millennium Development Goals. The MMR is even higher among urban and rural poor, recognized vulnerable groups. User fees at primary care facilities and for maternal healthcare constitute a barrier to access healthcare, particularly for vulnerable groups.

Waving the user fees at national level is one form of social protection to improve the access to healthcare. Another form of social protection is a social health insurance scheme. The objective of this project is to compare the cost-effectiveness of those two types of social protection and to determine the transmission channel from the short-term impact of the two approaches to medium-term inclusive growth. We do this using two programs each representing one of the two approaches and highly comparable in terms of time and space. We will measure the cost of both programs, as well as the impact of both programs in terms of targeting, quality of care, utilization and out-of-pocket expenditures.

The research will lead to informed policy advice on the most cost-effective strategies to target social protection programs, deliver quality care, increase utilization and reduce out-of-pocket expenditures, which ultimately should lead to inclusive growth.

Partner Institutions

  • Amsterdam Institute for International Development (AIID)
  • Health Policy Project Kenya (HPP)
  • PharmAccess Foundation (PAI)
  • Amsterdam Institute for Global Health and Development (AIGHD)

Project Period

  • May 2015 – May 2017

Project Funders

  • NWO Logo

    The Netherlands Organisation for Scientific Research ensures quality and innovation in science and facilitates its impact on society. Its main task is to fund scientific research at public research institutions in the Netherlands, especially universities....


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