BackgroundThere is a wide range of actions an individual could take when sick or injured such as self–care, consulting a traditional healer, or seeking treatment from a private or public health care facility. The specific action taken is influenced by individual characteristics, provider characteristics, societal factors, and geographical factors. A key individual characteristic is the ability to afford the required health care. The study examines the effect of poverty on an individual’s choice of a health care provider in the event of sickness or injury in Kenya.MethodsUsing data from the Kenya Integrated Household and Budget Survey carried out between 2005 and 2006, we estimate a multinomial probit model that links an individual’s poverty status to the individual’s health care provider choice. The choices are classified as none, non-modern, and modern. The model is estimated for four age groups: infants, children aged 1 to 5 years, children aged 6 to 14 years, and adults. We control for the potential endogeneity of poverty status.ResultsOur results indicate that for all age groups, the predictors of poverty include large household sizes and longer distances to the nearest health facility. We further find that poverty reduces the probability of visiting a modern health care provider amongst all age groups.ConclusionsPoverty has a negative effect on the individual’s demand for modern health care services, holding other factors constant. To encourage the use of modern health care facilities, therefore, requires the pursuit of poverty–reduction strategies. Some of the ways this could be done include lowering the household sizes and reducing the average distance to modern health care facilities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0560-y) contains supplementary material, which is available to authorized users.

The paper investigates the effect of adequate use of prenatal care on birth weight in Kenya using data from the Kenya Demographic and Health Survey of 2008–2009 together with additional administrative data. Both a single–level model and a multi–level model are estimated. The estimation strategy controls for potential sample selection bias, potential endogeneity of prenatal care, and potential unobserved heterogeneity. The results indicate that adequate use of prenatal care increases birth weight, holding other factors constant. We further observe that the single–level model overstates the effect of prenatal care on birth weight. The results imply that infant health can be improved by using prenatal care adequately. The study calls for the pursuit of policies that encourage adequate use of prenatal care by expectant mothers such as ensuring availability of skilled health care providers such as doctors and nurses at prenatal care clinics, reducing the average distances mothers have to cover when seeking prenatal care services, intensifying education of females as a way of empowering them to be able to make the right choices regarding when to seek prenatal care and from whom, and increasing income opportunities for households.

This study aimed at examining the relationship between public spending and economic growth and how the composition of government expenditure affects economic growth in Kenya using time series data from 1980 to 2014. To achieve the objectives, modified Granger causality and Autoregressive Distributed Lag model (ARDL) were used. The results revealed both short term and long term causality from economic growth to government expenditure but only short run causality from government expenditure to economic growth. Based on the economic classification, the long run ARDL regression results showed development expenditure promotes economic growth while government purchases have no significant effect on GDP. Other control variables such as inflation and unemployment had negative effect on economic growth. In terms of functional classification, the regression results showed that expenditure on education and infrastructure are important drivers of economic growth. The positive effect of health expenditure was not significant.  Further, the regression results indicated that domestic savings and trade openness had significant positive effect on economic growth. Based on the empirical findings this study therefore recommends resources to be directed towards financing public infrastructure investment to improve economic performance. The study also recommends increasing resource allocation in the education sector to improve efficiency and support skills and human capital development that are important in promoting economic growth through increases in labor productivity. The study also recommends policymakers to enhance domestic resource mobilization and pursue favorable trade policies aimed at fostering robust economic growth.

Objective:We compare the unit costs of providing Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) interventions to adolescent girls and young women (AGYW) reached across two sites, an urban (Nyalenda A Ward) and peri-urban (Kolwa East Ward) setting, in Kisumu County of Kenya.Design:Micro-costing, using the average cost concept during project initiation and early implementation.Methods:Adopting the implementer's (provider's) perspective, we computed and classified costs in the following categories for each sub-implementing partner: medical and professional staff, administrative and support staff, materials and supplies, building space and utilities, equipment, establishment, and miscellaneous. These costs were summed across sub-implementing partners in a site to obtain the site-level total costs. These are then divided by the total number of AGYW reached in each site to obtain the unit costs. Data were collected from July to September 2017.Results:The unit costs in the peri-urban area were about 1.9 times of those in the urban area. It cost about US$67 [or 170 International Dollars] to deliver the DREAMS intervention package to each AGYW reached in the urban area as compared with approximately US$129 (or 327 International Dollars) in the peri-urban area.Conclusion:First, it was generally more expensive to deliver DREAMS interventions in the peri-urban setting as compared with the urban setting. Second, the difference in unit costs was mainly driven by the building space and utilities. Strategies to lower intervention costs are needed in the peri-urban setting, such as using existing infrastructure (either governmental or nongovernmental) or other innovative ways to deliver the services.

This study aims at analyzing the effect of tax and debt-financed government expenditure on economic growth in Kenya using time series data from 1980-2014. Vector Error Correction Model (VECM) was used to analyze the data. The empirical findings showed that public investment expenditure financed by issuing debt has positive effect on economic growth. The results also indicated that financing government consumption expenditure using debt has negative effect on economic growth. With regards to tax revenue, the results indicated that tax financed public consumption spending affects economic growth negatively. Moreover, the results showed financing government investment expenditure using tax revenue promotes economic growth. Based on the findings, this study therefore recommends fiscal authorities in to use borrowing to finance investment expenditure as opposed financing consumption spending. Additionally, given the adverse effects of debt-accumulation on growth performance, policy makers should focus more on domestic revenue mobilization to finance government expenditures.