Investigating Access to Reproductive Health Services Using GIS: Proximity to Services and the Use of Modern Contraceptives in Malawi

• Published in: African journal of reproductive health Vol. 8; no. 2; pp. 164 - 179
• Main Author: Nathan J Heard, Ulla Larsen and Dairiku Hozumi
• Format: Journal Article
• Language: English
• Published: Nigeria Women's Health and Action Research Centre 01.08.2004
• Subjects: Attitude to Health - ethnology; Birth control; Contraception; Contraception - methods; Contraception - psychology; Contraception - utilization; Contraception Behavior - ethnology; Contraception Behavior - psychology; Contraception Behavior - statistics & numerical data; Data Interpretation, Statistical; distance; Family planning; Family planning services; Geographic Information Systems - organization & administration; GIS; Health care facilities; Health Care Surveys; Health Knowledge, Attitudes, Practice; Health planning; Health Policy; Health Services Accessibility - standards; Health Services Research - organization & administration; Health Status Indicators; Humans; integration; Logistic Models; Malawi; Multivariate Analysis; Parity; Population policy; Poverty - statistics & numerical data; Reproductive health; Reproductive health services; Reproductive Health Services - standards; Reproductive Health Services - utilization; Reproductive Medicine - statistics & numerical data; Residence Characteristics; Travel; Women - education; Women - psychology; Womens health services; Malawi
• ISSN: 1118-4841; 2141-3606
• DOI: 10.2307/3583189

This paper attempted to identify whether access to reproductive health services partly explains use of modern contraception in Malawi. Recent changes in Malawi's population policy have brought the state's population ambitions into alignment with the consensus reached at the International Conference on Population and Development held in Cairo in 1994. Concurrently, Malawi witnessed a large increase in the use of modern contraceptives from 7% in 1992 to 26% in 2000. A geographic information system (GIS) was employed to integrate health facility data from the Malawi health facilities inventory and global positioning data from the 2000 Malawi demographic and health survey. An effort to detect a plausible causal pathway was made by using distance to health services as a proxy variable for access to services. In a multivariate logistic regression analysis, after controlling for background variables traditionally associated with use of modern contraception, access could not be shown to explain use of modern contraception in Malawi. (Afr J Reprod Health 2004; 8[2]: 164-179 )