Improving access to healthcare in underserved rural areas

Sustainable Development Goal 3 aims to achieve good health and well-being for all, but access to healthcare is still constrained in rural areas in low- and middle income countries. In this thesis we study two health service delivery models to improve access to healthcare in underserved rural areas: mobile outreach teams and community health entrepreneurs.

First, we investigate the effectiveness of a decentralized approach for site reassignment where mobile outreach teams collaborate in team meetings and evaluate what drives the effectiveness. We propose a mixed-integer programming model for centralized site reassignment. We extend this model to represent the decentralized approach and develop a set of simple decision rules for this approach.

Second, we explore drivers of the need for outreach teams to provide contraceptive implant removals. We perform a regression analysis to identify drivers of the need for outreach removal services and how operational decisions impact this need.

Finally, we adopt a mixed-methods approach to study how to address cash constraints at community health entrepreneurs. We combine quantitative and qualitative evidence from a field experiment in Kenya and interviews in collaboration with social enterprise Healthy Entrepreneurs.