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

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.