How does infrastructure contribute to health service delivery in Kenya?

Health is an essential component of human capital formation, especially in the early years of the lifecycle. Despite recent progress made, the quality of health services in Kenya remains insufficient. Poor availability and quality of infrastructure is one factor, among others, that affect the provision of healthcare services.  Patients need good roads to access health facilities or cell-phone coverage to call for help.

In addition, proper roads are needed for staff and medicines to reach the facilities on time, electricity to ensure the functioning of medical fridges to store vaccines, as well as phone and internet coverage for medical staff to access information and improve their supply chain management.

While the impact of poor roads limiting access to health services on health outcomes has been studied in Kenya, Mozambique, and India, among other countries, more remains to be explored on the impact of infrastructure -or the lack of it- on the supply of health services and its quality.

To improve our understanding of this issue, a recent joint research paper from the World Bank Infrastructure and Human Development Chief Economist Offices – “Infrastructure matters: Complementarities with the quality of health service delivery in Kenya” – explores the links between infrastructure and the provision of health services.

What do we know about access to infrastructure at health care facilities in Kenya? 

The paper combines geospatial data on the location of health facilities, local economic characteristics, and access to infrastructure with the World Bank’s Service Delivery Indicators (SDI) survey, an exhaustive health facility survey which covers a nationally representative subset of facilities for 2018. According to the SDI survey, only 56% of primary-level health care facilities have access to stable electricity and only 15% of health facilities use ICT for supply chain management. 

In order to complement the survey questions related to infrastructure, the paper uses multiple sources of geospatial data on infrastructure to extensively evaluate access to roads, electricity, and internet coverage for each health facility. The detailed road quality data shows that health facilities are on average 2 km away from the nearest road of at least fair quality, with a large variation from 0 to 95 km. Figures 1, 2, and 3 show the spatially uneven access of facilities to electricity, internet infrastructure proxied by the 2G coverage, and road quality.

Figure 1: Access to electricity for health facilities using the Global Electrification Platform

Figure 2: Access to 2G coverage

Figure 3: Proximity to fair- or good-quality primary or secondary roads for health facilities