Does free maternity care improve uptake and save lives? Quasi-experimental evidence from Kenya
利用肯尼亚取消用户收费政策的准实验设计，研究发现该政策小幅提高了产前保健利用率，但对住院分娩、死亡率或医疗质量无显著平均影响。
Many assume that user-fees deter healthcare-seeking in low- and middle-income countries and are therefore partially responsible for high mortality rates. This paper estimates the causal effect of a national user-fee removal programme in Kenya on healthcare seeking and mortality, using a difference-in-differences design exploiting variation in treatment intensity across local communities. Results indicate a small increase in the uptake of antenatal care but no average effects on facility delivery, mortality or the quality of healthcare. Several potential mechanisms are examined and findings suggest heterogeneous treatment effects based on the physical accessibility of care as well as community-level preferences regarding household decision-making.