The Influence of Quality of Care on Fertility Outcomes in Kenya

Michele Steinmetz, University of Nebraska at Kearney

The purpose of this study is to examine how quality of care at service delivery providers, as defined by Bruce (1990) interacts with individual characteristics to explain fertility outcomes of women in Kenya in 1998 and 2003. The present study provides a new perspective and findings on the debate regarding the role of socioeconomic development and the diffusion of new ideas through family planning programs as well as insights into how these factors may be influencing a stall in fertility decline in Kenya. By investigating individual-level fertility outcomes in Kenya, utilizing multi-level models applied to a unique data set integrating community-level development and family planning service quality of care indicators with nationally representative Demographic and Health Survey data from 1998 and 2003 and clinic-level data from 1999 and 2004 this study will test both direct and interactive effects of community context on changing fertility behaviors and outcomes.