The distance-quality trade-off in women’s choice of family planning provider in North Eastern Tanzania

Datos Bibliográficos

ID21879947
AutoresBilikisu Elewonibi (Harvard University, autor de correspondencia), Ryoko Sato (0000-0001-7040-317X, Harvard University), Rachel Manongi (0000-0003-3841-974X, Kilimanjaro Christian Medical Centre), Sia E Msuya (0000-0003-2248-2058, Kilimanjaro Christian Medical Centre), Sia Msuya (Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, United Republic of Tanzania), Ikram Shah (0000-0001-8850-4374, Harvard University), David Canning (0000-0003-4041-1229, Harvard University)
Año2020
Volumen5
Número2
Páginase002149
Fecha de publicación2020-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2019-002149
PMID32133195
OpenAlexW3006129324
IdiomaEN
Citas recibidas6
Referencias citadas16

Introduction: Studies on the determinants of contraceptive use often consider distance to the nearest health facility offering contraception as a key explanatory variable. Women, however, may not seek contraception from the nearest facility, rather opting for a more distant facility with better quality services or to ensure greater privacy and anonymity. Methods: The dataset used include the name of facility where each women obtained contraception, measures of facility quality, and the distance between each woman's home and 39 potential facilities she might visit. We use a conditional-multinomial logit model to estimate the determinants of her facility choice to visit and how women tradeoff travelling longer distances to use higher quality facilities. Results: Only 33% of woman who received contraception from a health facility used their nearest facility. While the nearest facility was 1.2 km away, the average distance to facility used was 2.9 km, indicating women are willing to travel significantly longer distances for higher quality. Women prefer facilities that specialise in providing contraception, provide a large range of methods, do not suffer from stock outs and do not charge fees. Furthermore, on average, women are willing to travel an additional 2 km for a facility that offers more family planning methods, 4.7 km for a facility without one additional health service, 9 km for a facility without fees for contraception and 11 km for a facility not experiencing stock out of an additional contraception. Conclusion: Our results suggest that quality of services provided is an important driver of facility choice in addition to distance to facility

Business · Economics · Environmental health · Family planning · Health facility · Health services · Multinomial logistic regression · Population · Socioeconomics · Statistics · Tanzania · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Reproductive Health and Contraception