Kelly Jones

The purpose of this study is to assess the returns to reproductive health services (RHS) such as family planning and maternity care in the context of Kenya. While such services are readily accessible in the developed world, governments and NGOs struggle to provide even basic RHS in poor countries. Yet the return to such investments is not clearly known. Factors correlated with the ability or willingness to access these services often confound efforts to estimate such returns. This analysis makes use of an exogenous change in U.S. policy regarding development assistance, known informally as the global gag rule. Under this policy, organizations that refused to alter activities to match U.S. policy lost all USAID funding. The 2001 reinstitution of the gag rule significantly reduced the budgets of NGO providers of RHS. Service cutbacks by such organizations reduced availability of RHS to varying degrees in different communities throughout Kenya. The policy impact assessment employs geocoded Demographic and Health Survey (DHS) data, which provides information on maternity services received and use of contraception between 1998 and 2003, as well as the outcomes of interest. These data are combined with detailed institutional data collected from nonsignatory NGOs regarding service provision and user fees at each of the 35 affected clinics over the same period. Preliminary results suggest that the policy significantly reduced provision of maternity services such as antenatal care, delivery in a clinic or hospital, and postpartum health checks for those living within the catchment area of a clinic operated by a nonsignatory NGO. After assessing the impact of the policy on service provision, the policy change will be used as an instrument to identify the impact of RHS on maternal and child health outcomes. Outcomes of interest include indicators of health at birth, child health, and human capital development (schooling), as well as maternal health.

Contact Information:
Kelly Jones, kelly.jones@berkeley.edu, University of California, Berkeley