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Citation

Tumlinson, Katherine; Britton, Laura E.; Williams, Caitlin R.; Wambua, Debborah Muthoki; & Otieno Onyango, Dickens (2021). Informal Payments for Family Planning: Prevalence and Perspectives of Women, Providers, and Health Sector Key Informants in Western Kenya. Sexual and Reproductive Health Matters, 29(1), 1-17. PMCID: PMC8494287

Abstract

Informal payments are off-the-record financial transactions made by patients to their healthcare providers. Providers in low- and middle-income countries solicit informal payments from patients to purchase additional supplies, supplement wages, or for other reasons. Informal payments reduce equitable access to healthcare services and undermine efforts to ensure universal health coverage. This study used multiple data collection methods to estimate the prevalence of informal payments, describe the impact, and explore feasible solutions for curbing this practice in western Kenya. Facility-level data were collected in 60 public sector facilities (contributing 142 mystery client visits and, in a subsample of 10 facilities, 253 client-provider observations). We conducted 8 focus groups with current and prior contraceptive users, 19 key informant interviews, and 2 journey mapping workshops. Providers solicited informal payments in 25% of mystery client visits and 13% of client-provider observations; the median amount of money requested from mystery clients was 1 USD. Focus group and journey mapping participants reported informal payments are a financial barrier and contribute to unintended pregnancy; key informants suggested greater community monitoring of facilities is key for reducing this behaviour.

URL

http://dx.doi.org/10.1080/26410397.2021.1970958

Reference Type

Journal Article

Year Published

2021

Journal Title

Sexual and Reproductive Health Matters

Author(s)

Tumlinson, Katherine
Britton, Laura E.
Williams, Caitlin R.
Wambua, Debborah Muthoki
Otieno Onyango, Dickens

Article Type

Regular

PMCID

PMC8494287

Continent/Country

Kenya
LMICs

ORCiD

Tumlinson - 0000-0001-8314-8219