Quantifying the impact of accessibility on preventive healthcare in sub-Saharan Africa using mobile phone data
Department of Engineering and p'Ublic Policy, Carnegie Mellon University, Pittsburgh, PA, United States; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, United States; Center for Communicable Disease Dynamics, Harvard School of Public Health, Boston, MA, United States; Department of Medicine, Duke University and Duke Global Health Institute, Durham, NC, United States; Department of Geography and Environment, University of Southampton, Highfield, Southampton, United Kingdom; Fogarty International Center, National Institutes of Health, Bethesda, MD, United States; School of Public Health Moi University, Eldoret, Kenya; Department of Computer Science, Northeastern University, Boston, MA, United States
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 14,816,521 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. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Africa south of the Sahara; Article; child; female; health care access; health care facility; household; human; immunization; Kenya; lowest income group; major clinical study; mobile phone; prenatal care; preventive health service; priority journal; vulnerable population; adult; developing country; health care delivery; health care survey; infant; longitudinal study; pregnancy; preschool child; statistics and numerical data; time; travel; utilization; vaccination; Adult; Cell Phones; Child, Preschool; Developing Countries; Female; Health Care Surveys; Health Services Accessibility; Humans; Infant; Kenya; Longitudinal Studies; Pregnancy; Prenatal Care; Time Factors; Travel; Vaccination
FIC, National Institutes of Health; NIH, National Institutes of Health