Do active patients seek higher quality prenatal care?: A panel data analysis from Nairobi, Kenya

Area of Science:

• Health Services Research
• Global Health
• Patient Behavior

Background:

• Growing evidence suggests patients in low-income countries are increasingly active in selecting healthcare providers.
• Urban centers like Nairobi, Kenya, with diverse healthcare options, provide a unique setting to study patient choice.

Purpose of the Study:

• To investigate the prevalence, characteristics, and care-seeking behaviors of "active" antenatal care (ANC) patients in Nairobi.
• To determine if active ANC patients seek higher quality care and report greater satisfaction.

Main Methods:

• Utilized a unique panel dataset from 2015, interviewing 402 pregnant women in peri-urban Nairobi three times.
• Defined active ANC patients as those who switched providers during pregnancy.
• Analyzed patient characteristics, facility choices, and satisfaction levels.

Main Results:

• Active ANC patients were more educated and more likely to have high-risk pregnancies.
• These patients increasingly opted for private care (even when public care was free) and received higher quality care.
• Active patients reported higher satisfaction and were more likely to deliver at their ANC facility.

Conclusions:

• Active patient behavior in selecting ANC providers is linked to seeking higher quality care and improved satisfaction in Nairobi.
• Patient empowerment and choice in healthcare settings with numerous providers can lead to better perceived quality of care.