Pregnant women’s travel time to hospital in African cities can take four times longer than models predict

Today, estimated travel times to hospital in large African cities are based on traditional computer models that use geographic information systems. However, in a newly published article in BMJ Global Health, researchers from the London School of Economics and Political Science, London School of Hygiene and Tropical Medicine and the Institute of Tropical Medicine (ITM) in Antwerp reveal that the actual travel time to a hospital in Lagos can take up to four times as long as the existing tools predict. It is very likely that this is the case in other big African cities as well.

New research reveals that in reality, pregnant women can take up to four times as long as traditional computer models estimate to travel to hospitals in Lagos. Furthermore, their real journeys compared to estimates from Google Maps can take as much as one and a half times longer. “There are huge life and death implications of travel time to reach facilities for pregnant women in emergency situations”, says Dr Aduragbemi Banke-Thomas from the London School of Economics and Political Science. “The World Health Organization recommends that women should be able to access health facilities within two hours. As per our study, computer model and Google estimates suggested that all the pregnant women in this study reached health facilities within two hours, but in reality, most women travelled much longer.”

The researchers extracted data from more than 700 pregnant women with potentially life-threatening complications in Lagos. They estimated the women’s travel time using computer models and Google Maps. By then sending drivers to reconstruct the actual journeys at the exact same time and day of the week as the women had travelled, they realised that the women’s actual travel time took much longer than the existing models predicted. “This disparity is due to many different reasons such as traffic, the poor state of roads, rain, and other factors that models do not currently keep into account”, says Dr Lenka Benova from the Institute of Tropical Medicine in Antwerp.

“Historically, minimal attention has been given to understanding travel time of pregnant women to health facilities in situations of emergency in large African cities. It is crucial that travel time estimates for critical maternal health services in African cities get a more pragmatic, true to life approach.” Dr Aduragbemi Banke-Thomas concludes: “Reaching such findings obscures inequality in access. This minimises the utility of these models, and large-scale models in particular may not be effective for advocacy, service planning and policymaking.”

Link to blogpost: https://blogs.lse.ac.uk/africaatlse/2021/01/28/health-seeking-travel-hospital-nigeria-pregnancy/