ArticleStudies in family planning2020
"If the Big Fish are Doing It Then Why Not Me Down Here?": Informal Fee Payments and Reproductive Health Care Provider Motivation in Kenya.
Article in Studies in family planning, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Facilitators and barriers of healthcare financing modalities for universal maternal healthcare services in East Africa: a qualitative systematic review.BMC health services research · 2025Pooled it
- The hidden financial burden of healthcare: a systematic literature review of informal payments in Sub-Saharan Africa.Wellcome open research · 2021Pooled it
- Informal and out-of-pocket payments for public-sector contraceptive care in remote Madagascar.Contraception · 2026Article
- Beyond the price tag: a scoping review of the determinants of informal payments in health systems and strategies for curbing them.BMC health services research · 2026Article
- Factors associated with Senegalese health workers' willingness to receive mobile digital payments: cross-sectional study.BMJ global health · 2025Article
- Barriers to contraceptive implant removal among current and prior implant users in Kisumu, Kenya: Results from a cross-sectional population-based survey.PLOS global public health · 2025Article
- Findings from a mixed-methods journey map study of barriers to family planning in western Kenya.Health care for women international · 2024Article
- Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers.BMC pregnancy and childbirth · 2023Article
- Contraceptive stockouts in Western Kenya: a mixed-methods mystery client study.BMC health services research · 2023Article
- Absenteeism among family planning providers: a mixed-methods study in western Kenya.Health policy and planning · 2022Article
- Informal payments for modern family planning methods at public facilities in Tanzania: room for improvement.Human resources for health · 2022Article
- How are health workers paid and does it matter? Conceptualising the potential implications of digitising health worker payments.BMJ global health · 2022Article
- Free Access to a Broad Contraceptive Method Mix and Women's Contraceptive Choice: Evidence from Sub-Saharan Africa.Studies in family planning · 2021Article
- "When it comes to time of removal, nothing is straightforward": A qualitative study of experiences with barriers to removal of long-acting reversible contraception in Western Kenya.Contraception: X · 2021Article
- "Women's health (London, England)Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Informal fees are payments made by patients to their health care provider that are over and above the official cost of services. Payments may be motivated by a combination of factors such as low supervision, weak sanctions, and inadequate provider salaries. The practice of soliciting informal fees from patients may result in restricted access to medical care and reduced care-seeking behavior among vulnerable populations. The objective of this study is to examine nuanced health care provider perspectives on informal fee payments solicited from reproductive health patients in Kenya. We conducted in-depth semistructured interviews in 2015-2016 among a sample of 20 public and private-sector Kenyan health care workers. Interviews were coded and analyzed using an iterative thematic approach. More than half of participants reported that solicitation of informal fees is common practice in health care facilities. Providers reported low public-sector wages were a primary driver of informal fee solicitation coupled with collusion among senior staff. Additionally, patients may be unaware that they are being asked to pay more than the official cost of services. Strategies for reducing this behavior include more adequate and timely remuneration within the public sector, educating patient populations of free or low-cost services, and evidence-based methods to increase provider motivation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.