Comparing modelled with self-reported travel time and the used versus the nearest facility: modelling geographic accessibility to family planning outlets in Kenya. Issue 5 (6th May 2022)

• Record Type: Journal Article
• Authors: Bouanchaud, Paul; Macharia, Peter M; Demise, Eden G; Nakimuli, Doreen
• Other Names: author non-byline.; Anyanti Jennifer author non-byline.; Archer Justin author non-byline.; Ashburn Kimberly author non-byline.; Bakira Henry author non-byline.; Bouanchaud Paul author non-byline.; Buyungo Peter author non-byline.; Clary Caitlin author non-byline.; Conlon Mark author non-byline.; Demise Eden author non-byline.; Duff Kevin author non-byline.; Ekhator-Mobayode Uche author non-byline.; Elmasry Hoda author non-byline.; Essendi Hildah author non-byline.; Freeman Jordan author non-byline.; Gibbs Susannah author non-byline.; Griffin Risa author non-byline.; Heard Nathan author non-byline.; Hu Bo author non-byline.; Jackson Ashley author non-byline.; Kalamar Amanda author non-byline.; Keller Brett author non-byline.; Kyomuhangi Irene author non-byline.; Lukwago Baker author non-byline.; Macharia Peter author non-byline.; Malmqvist Alison author non-byline.; Momanyi Harmon author non-byline.; Mugerwa Micheal author non-byline.; Nakimuli Doreen author non-byline.; Njogu Julius author non-byline.; Nwala Anthony author non-byline.; Nyende Noah author non-byline.; Olemo Daniel author non-byline.; Olila Jacob author non-byline.; Om'Iniabohs Alyssa author non-byline.; Onyezobi Chinedu author non-byline.; Rhoda Dale author non-byline.; Rothschild Claire author non-byline.; Songo Raymond author non-byline.; Sudoi Raymond author non-byline.; Udoh Ekerette Emmanuel author non-byline.; Wheatley Nkemdiri author non-byline.; Yang Wei author non-byline.;
• Is Part Of: BMJ global health. Volume 7:Issue 5(2022)
• Publication Date: 2022-05-06
• Subjects: health policy -- medical demography -- public health -- other study design; World health -- Periodicals; 362.105
• DOI: 10.1136/bmjgh-2021-008366
• Languages: English
• ISSNs: 2059-7908

Abstract

Abstract : Introduction: Geographic access to family planning (FP) services has been characterised through a variety of proximity metrics. However, there is little evidence on the validity of women's self-reported compared with modelled travel time to an FP outlet, or between different distance measures. Methods: We used data from four urban sites in Kenya. A longitudinal FP outlet census was directly linked with data from cross-sectional FP user surveys. We combined characteristics of outlet visited to obtain FP, transport mode, self-reported travel time and location of households and outlets with data on road networks, elevation, land use and travel barriers within a cost-distance algorithm to compute modelled travel time, route and Euclidean distance between households and outlets. We compared modelled and self-reported travel times, Euclidean and route distances and the use of visited versus nearest facility. Results: 931 contraceptive users were directly linked to their FP source. Self-reported travel times were consistently and significantly higher than modelled times, with greater differences for those using vehicles rather than walking. Modelled and Euclidean distances were similar in the four geographies. 20% of women used their nearest FP outlet while 52% went to their nearest outlet when conditional on it offering their most recently used FP method. Conclusion: In urban areas with high facility density and good road connectivity, over half of FP users visited their nearest outlet with their chosen method available. In these settings, Euclidean distances were sufficient to characterise geographic proximity; however, reported and modelled travel times differed across all sites.