Health Facility Reachability Index: Geospatial Analysis of Demographic Health Vulnerability and Marginalization

Samuel Mwangi, Tübingen University
Carol Ndiritu, University of Nairobi
Joseph Gitahi, University of Applied Sciences Stuttgart

The availability of health facilities is a factor for modern family planning uptake and fertility rates. But under most countries, the number of health facilities in an area is determined by the population size. Such a policy is usually in favor of dense populations and against people in sparsely populated regions. This thereby produces marginalization based on population density. We determine the geographical area served by a health facility and establish a Health Facility Reachability Index (HRI). We then conducted a regression of both HRI and the number of health facilities on access to modern family planning and fertility rates. The findings indicate that the use of the number of health facilities alone does not explain the low uptake of family planning and high fertility rates in the two regions under study. Also, the failure to consider the distance to reach a health facility hides marginalization of people in health care access in sparsely populated areas.