Infrastructure Matters
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World Bank, Washington, DC
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In many low- and middle-income
countries, the lack of access to essential infrastructure
such as roads, electricity, and information and
communications technology may hinder the provision of many
critical services such as health care. For instance, scarce
and deficient roads might limit the patients’ access to
health facilities, restrict the supply of qualified staff,
and constrict access to key inputs such as medicines and
vaccines. Likewise, lack of reliable electricity and
internet connection may limit the ability of health
facilities to power essential equipment, have better access
to information, potentially serve more patients, and manage
their supply chain efficiently. This paper combines
exhaustive health facility surveys with geospatial data to
study the extent to which better access to infrastructure in
Kenya might improve the functioning of health care
facilities and the quality of their services. First, the
paper documents the gap in access to infrastructure in the
health care sector in Kenya and reviews the literature on
this topic. Then, using a novel data set, it finds that
access to electricity and good quality roads is associated
with more accurate provider diagnostics for both general
illnesses and those primarily affecting children and
pregnant women. Additionally, access to electricity is
associated with (i) higher availability of vaccines for
children—mostly by making it possible to have a working
fridge, which is essential to store most vaccines; and (ii)
higher availability of essential and priority medicines, by
facilitating the use of information and communications
technology for supply chain management. Finally, access to
good quality roads, electricity and use of information and
communications technology for supply management are
positively related to the availability of antenatal care
tests for pregnant women. Overall, the results suggest that
increased investment in infrastructure and communications
technologies may improve health service provision in Kenya.
Palabras clave
HEALTH FACILITIES, INFRASTRUCTURE, ROADS, ELECTRICITY, ICT, PROVISION OF SERVICES INFRASTRUCTURE, INTERNET ACCESS IMPACT, HEALTH SERVICE DELIVERY
