Quantifying the impact of accessibility on preventive healthcare in sub-Saharan Africa using mobile phone data

Wednesday, 21st of October 2015

Abstract

BACKGROUND:

Poor physical access to health facilities has been identified as an important contributor to reduced uptake of preventive health services and is likely to be most critical in low-income settings. However the relation among physical access travel behavior and the uptake of healthcare is difficult to quantify.

METHODS:

Using anonymized mobile phone data from 2008 to 2009 we analyze individual and spatially aggregated travel patterns of 14816521 subscribers across Kenya and compare these measures to (1) estimated travel times to health facilities and (2) data on the uptake of 2 preventive healthcare interventions in an area of western Kenya: childhood immunizations and antenatal care.

RESULTS:

We document that long travel times to health facilities are strongly correlated with increased mobility in geographically isolated areas. Furthermore we found that in areas with equal physical access to healthcare mobile phone-derived measures of mobility predict which regions are lacking preventive care.

CONCLUSIONS:

Routinely collected mobile phone data provide a simple and low-cost approach to mapping the uptake of preventive healthcare in low-income settings.

The relationship between mobility travel times and households missing preventive healthcare. A The percentage of households (HHs) within each area’s sublocation who reported missing antenatal care (ANC). The entire study area and a sample study site are shown. B The predicted percentage of eligible HHs missing ANC per sublocation using travel times to the nearest health facility (HF) (red) or the mobility values from the mobile phone data (blue) (reduction in deviance from the mobility model 3%; from the travel-time model 0.41%). The travel-time data would predict that nearly every sublocation is missing the same percentage whereas the mobile phone data provides more accurate estimates over a wider range.