It’s further than we thought…

New research explores family planning users’ perceptions of distance to contraceptive outlets in Kenya

By Paul Bouanchaud, Senior Research Advisor, PSI

If we hope to improve women’s access to family planning (FP), it is essential that we understand their decision-making and experience when accessing FP services and products. Analogous to perceptions of FP service quality, women’s perceptions of how long it takes to get to an FP outlet are likely as important as an objective measure of that distance or time.  

Rarely though, do we get the chance to compare the two. That is, until now. 

How do consumers’ perceptions of time taken to get to an outlet compare to the geographic data-based models of travel times that we typically use? Do FP users visit the outlets nearest to their homes, and if not, how much further do they travel to access their FP methods? Using the CM4FP project’s unique dataset that directly links FP users to the outlet that they visited for products or services, we answered these questions across four urban and semi-urban sites in Kenya. What did our research in a recently published article in BMJ Global Health show? And how can these findings help us to improve FP access for women – everywhere, every time? 

What did we find?

Across the four urban and semi-urban sites in Kenya, current FP users: 

  1. Estimated that the time it took for them to travel to get their FP method was around double the time projected based on the measured distance between their home and the outlet. This was true regardless of the form of transport the FP user had taken, although the times estimated by those who traveled by foot were closer to the modelled times than those traveling by other means of transport.  
  2. Challenging the assumption that convenience is the most important factor in FP outlet choice, we found that only one in five women went to their closest outlet – with a caveat. Digging further into the data, we found that once we excluded outlets that didn’t have their chosen FP method in stock, one in two women went to their nearest outlet.  
How Can These Findings Help Us Improve Access to FP?

Understanding how the FP market looks from the consumers’ perspective challenges our current measurement methods and assumptions, giving us a more nuanced view of access and utilization. Knowing that only around half of women are visiting the geographically nearest outlet to their home that stocks their chosen product gives us a couple of things to think about. 

First, it reinforces the importance of factors other than proximity in outlet choice for at least half of women; client experience and perceived service quality are likely to be important drivers here. 

Meanwhile, if travel time is indeed an important factor for consumers, it’s useful to know that the models we use are likely to underestimate how long consumers think it takes to get to an outlet. If perceived access to is an important factor in getting healthcare – as we think it probably is – then these findings are important to better understand how women access FP in their communities.  

We’re using these results to think about what we can do to bring quality FP products and services closer to those who need them – how can we work together to make healthy choices easier for consumers?

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