ArticleBMC health services research2021
A retrospective study of the impact of health worker strikes on maternal and child health care utilization in western Kenya.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Impacts of industrial actions, protests, strikes and lockouts by health and care workers during COVID-19 and other pandemic contexts: a systematic review.Human resources for health · 2024Pooled it
- Strikes of physicians and other health care workers in sub-Saharan African countries: a systematic review.Frontiers in public health · 2024Pooled it
- "If they were telling us to go, we will go": factors associated with effective postnatal care coverage before and after discharge - a mixed-methods study in rural western Kenya.BMJ global health · 2026Article
- From devolution to post-COVID-19 UHC scoping review of human resource for health reforms in Kenya: a signalling and sensemaking analysis.Frontiers in health services · 2026Article
- Concordance of coverage estimates from routine and survey data of measles second dose vaccine in Western Kenya.Frontiers in epidemiology · 2025Article
- A look back at the strike by Mozambican doctors in 2013: what can we learn?BMC health services research · 2024Article
- Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
- Public-Private engagement and health systems resilience in times of health worker strikes: a Ghanaian case study.Health policy and planning · 2024Article
- Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review.International journal of environmental research and public health · 2024Article
- Simulation and team training to improve preterm birth knowledge, evidence-based practices, and communication skills in midwives in Kenya and Uganda: Findings from a pre- and post-intervention analysis.PLOS global public health · 2023Article
- Sources of stress and coping mechanisms: Experiences of maternal health care providers in Western Kenya.PLOS global public health · 2023Article
- Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.BMC pregnancy and childbirth · 2022Article
- 'It was hell in the community': a qualitative study of maternal and child health care during health care worker strikes in Kenya.International journal for equity in health · 2021Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere have been dozens of strikes by health workers in Kenya in the past decade, but there are few studies of their impact on maternal and child health services and outcomes. We conducted a retrospective survey study to assess the impact of nationwide strikes by health workers in 2017 on utilization of maternal and child health services in western Kenya.
methodsWe utilized a parent study to enroll women who were pregnant in 2017 when there were prolonged strikes by health workers ("strike group") and women who were pregnant in 2018 when there were no major strikes ("control group"). Trained research assistants administered a close-ended survey to retrospectively collect demographic and pregnancy-related health utilization and outcomes data. Data were collected between March and July 2019. The primary outcomes of interest were antenatal care (ANC) visits, delivery location, and early child immunizations. Generalized estimating equations were used to estimate risk ratios between the strike and control groups, adjusting for socioeconomic status, health insurance status, and clustering. Adjusted risk ratios (ARR) were calculated with 95% confidence intervals (95%CI).
resultsOf 1341 women recruited in the parent study in 2017 (strike group), we re-consented 843 women (63%) to participate. Of 924 women recruited in the control arm of the parent study in 2018 (control group), we re-consented 728 women (79%). Women in the strike group were 17% less likely to attend at least four ANC visits during their pregnancy (ARR 0.83, 95%CI 0.74, 0.94) and 16% less likely to deliver in a health facility (ARR 0.84, 95%CI 0.76, 0.92) compared to women in the control group. Whether a child received their first oral polio vaccine did not differ significantly between groups, but children of women in the strike group received their vaccine significantly longer after birth (13 days versus 7 days, p = 0.002).
conclusionWe found that women who were pregnant during nationwide strikes by health workers in 2017 were less likely to receive WHO-recommended maternal child health services. Strategies to maintain these services during strikes are urgently needed.
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