Estimating the Distance-Quality Tradeoff for Health Facility Choice in Tanzania Using a Novel Dataset

Bilikisu Elewonibi , Harvard School of Public Health
Ryoko Sato, Harvard School of Public Health
Rachel Manongi, Kilimanjaro Christ Medical College
Sia Msuya, Killimanjaro Christian University College, Moshi
Iqbal H. Shah, World Health Organization (WHO)
David Canning, Harvard University

Women may not seek family planning (FP) services from the nearest facility rather opting for those with better quality services. We use a new dataset on women and facility quality to provide evidence that women are willing to travel further distances for higher quality FP services in Tanzania. Unlike the DHS, we have exact GPS locations of women and facilities, as well as the name of the facility each women selected. Facility quality indicators include the number of FP methods offered and FP fees. We use a conditional-multinomial logit model to estimate that, on average, women are willing to travel an additional 1.7 km to a facility with 1 more FP method and 12 km to a facility without FP fees. Results show that women are willing to travel longer distances for higher quality, and free services, and there is a need to increase access to high quality services rather than just increasing access to any service.

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 Presented in Session 129. Fertility, Family Planning, and Reproductive Health: Programs and Quality of Care