Factors governing household access to key socio-economic facilities and their influence on education performance and healthcare seeking behaviour in rural communities of Malawi

• Main Author: Kuotcha, Witness Shaibo
• Published: University of Strathclyde 2014
• Subjects: 624
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.618870

It has been recognized that spatial pattern of activities and how they are connected by the transportation system determines the accessibility of a particular location. It has also been acknowledged that identification of locations with poor accessibility to key services is an important first step in the development of appropriate social and health policy interventions. Moreover, the current literature acknowledges that the lack of accessibility to basic goods and services deepens the isolation of rural households, undermining their opportunities to access socio - economic and basic services. Therefore, provision of effective interventions to reduce the lack of access to basic facilities/services would go a long way to improving peoples' well being in rural areas. From a policy perspective, to ensure that resources are properly targeted, it is important to identify (1) communities that are most deprived in terms of their access to key facilities and (2) how the levels of accessibili ty affect the health, social and economic well being of the local communities. The focus of this study is to contribute to point (1), and in particular to proper understanding of point (2). The analysis of this thesis is based on household survey data from a sample of 989 households across thirty villages in a rural district of Malawi. The study employed GIS, TransCAD 4.8 (Caliper Corporation, 2005) tool to estimate distances from the villages to the nearest key facilities. Using SPSS version 19.0 (SPSS, 2010), a series of binary and ordinal logistic regression models were performed to estimate the influence of distance, local topography, state of road network and socio-economic characteristics on (i) school attendance and educational performance and (ii) rural health care seeking behaviour. In addition, a series of bivariate analysis were performed to investigate the trade-offs between school attendance and (i) farm tasks and (ii) water collection. The main contribution of this thesis is in Chapters Six, Seven and Eight. The results suggested that a significant number of villages in Chikwawa district were far from key services and the general state of the road network in most villages was poor. It was established that distance was the strongest predictor of school attendance and healthcare seeking behaviour. It was also established that villages located close to schools benefited by (a) lower levels of absenteeism and (b) more time available for farm tasks. The thesis recommends a balanced mix of transport policies that (i) takes into account the actual modes of transport used, (i) aims at improved local (3)4z(Bnon-car(3)4y) Bpaths and footbridges alongside a cost-effective road network and (iii) aims at encouraging a better spread of activity locations.