title: Quantifying the impact of accessibility on preventive healthcare in sub-Saharan Africa using mobile phone data.
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 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.
authors: From the aDepartment of Engineering and P`ublic Policy, Carnegie Mellon University, Pittsburgh, PA; bDepartment of Epidemiology, Harvard School of Public Health, Boston, MA; cCenter for Communicable Disease Dynamics, Harvard School of Public Health, Boston, MA; dDepartment of Medicine, Duke University and Duke Global Health Institute, Durham, NC; eDepartment of Geography and Environment, University of Southampton, Highfield, Southampton, United Kingdom; fFogarty International Center, National Institutes of Health, Bethesda, MD; gSchool of Public Health Moi University, Eldoret, Kenya; and hDepartment of Computer Science, Northeastern University, Boston, MA.
authors: Amy
authors: A
authors: Wesolowski
authors: Wendy Prudhomme
authors: WP
authors: O'Meara
authors: Andrew J
authors: AJ
authors: Tatem
authors: Samson
authors: S
authors: Ndege
authors: Nathan
authors: N
authors: Eagle
authors: Caroline O
authors: CO
authors: Buckee
mesh_terms: D000328:Adult; D040421:Cell Phone; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007630:Kenya; D008137:Longitudinal Studies; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D013997:Time Factors; D014195:Travel; D014611:Vaccination / Q000706:statistics & numerical data*
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