After the road has been paved, then what?

developing an accessibility focus for Africa.

Talia McCray

The focus for Africa should not be simply on the building of roads. Instead, the focus of attention should be centered on creating opportunities for access. By creating opportunities for people to live meaningful lives through employment, attending school, shopping, and accessing quality health care, transportation becomes an integral part of achieving the Millennium Development Goals.

This paper explores the concept of accessibility and suggests ways of measuring it in three studies. The first study focuses on prenatal care access in rural South Africa. The second study addresses the challenges of using public transit for low-income women in Quebec City, Canada,. The final study presented showcases a methodology used to involve low-income and immigrant teenagers in Providence, RI, to document their activity patterns and how their perceptions of safe/unsafe places shape their travel patterns.

The three studies highlighted in this document illustrate the complexity in addressing the issue of access. Access pervades all aspects of the human existence. Chapin’s theoretical framework provides a conceptualization of two fundamental components; desire and opportunity (1974). First the individual must desire to engage in the activity and second, the opportunity to engage in the activity must exist. However, the degree to which access is shaped by a society’s culture and social norms is not addressed. This dimension is very important in understanding the accessibility challenges of women living in Africa and other developing countries. Studies have documented the negative impacts of daily household responsibilities on rural women’s mobility (Taser, Hosegood, Benzler, & Solarsh, 2001; Kane, 2003; McCray, 2004). Kane found that African girls attend and complete school at a much lower rate than boys, due to the responsibilities of caring for younger siblings and fetching water (2003). McCray’s findings support the negative impact of daily activities on young women seeking prenatal care (2004).

Detailed below is an outline of the three studies.

South African prenatal care study (McCray, 2004)

Research Questions addressing the prenatal care level

• What factors encourage/discourage women from making a trip to a health facility for PC?

• What daily activities negatively impact a woman’s decision to make a trip to a health facility?

• Are there differences among utilization groups? (sociodemographic/sociocultural factors)

Study Sample (collected in 1998)

• 327 homesteads selected from an initial random sample of 646 homesteads obtained from a GIS database.

• Interviewed one woman per homestead with a living child between the ages of 12-23 months.

• Separate study conducted at 5 clinics: Madonela, Makhathini, Mbazwana, Ntshongwe, and Ophansi.

Data Analysis

• Prenatal Care (PC) level served as the dependent variable

· High Utilizers - began 1st trimester and went 5 or more times (N=137, 44%)

· Average Utilizers - began 2nd trimester and went 5 or more times (N=121, 39%)

· Low Utilizers - all others (N=56, 18%)

• Variables significantly associated with PC utilization level included

· The age of the mother: p<0.05

· Parity, the number of previous live births, marginally associated: p=0.061

· Whether someone advised the pregnant woman to obtain prenatal care: p<0.05

· Whether someone used the nearest health care facility: p<0.05

· Activities that conflict with a trip to the clinic:

• Fetching water: p<0.05

• Working in the fields: p<0.05

Analysis Results

• A standard multinomial model is used to analyze the data.
• Despite the challenges of mobility and other social/environmental factors, women utilized services at high levels.
• Women who received advice to obtain care were two times more likely to utilize prenatal care services at a high level than a low level.
• Since this society practices polygamy, childcare was not a significant factor associated with how well a woman utilized prenatal care services.
• Women who went to the nearest residential clinic were three times more likely to be high utilizers than low utilizers.
• Women, who reported that their ability to fetch water was negatively impacted by a need to visit the clinic, were two times more likely to utilize prenatal care services at a low level than other women participating in the study.

Exploring the role of transportation in designing methodology to address perceptions of social exclusion related to public transit in Quebec City, Canada

(McCray & Brais, 2007)

Motivation for research

• Quebec City and Toronto were conducting a 4 year panel survey to address accessibility & social equity. However, low-income individuals are missing from their study.
• This off-shoot study in a small way tries to address some interesting areas: Why do people do what they do, and what factors, including their perceptions, affect their destination choices?
• Explore the use of GIS to inform and enhance qualitative data to address issues of social exclusion for women who are public transit dependent.

Study sample

• 5 Women Centers

· 2 in the urban core & 3 in the first ring of suburbs

• 34 women participated

• 3 hour sessions (childcare & lunch provided)

Data Analysis

• Developed an innovative focus group format.

· Group discussions address accessibility needs, use of public transit, and attitudes towards public transit

· Self mapping exercise addresses perceptions of space, depth of space, and mobility travel effort.

· Survey is administered addressing socioeconomic factors, modal use, and places of contact.

• A standard distance spatial model is used to measure the dispersion of regular and occasional activities in the final analysis.

• GIS allows the mixing qualitative and quantitative data from all respondents to capture how perceptions, the environment, and public transportation shape the activity spaces of low-income women.

Analysis Results and Discussion

• Methodology found to be valuable in exploring the extent of individual action space.

· Regular activities are often closer to the home location than occasional activities.

· Drivers appear to have a greater action space than transit users or walkers.

· Modal use is seasonal dependent.

· Single mothers living in the urban core appear to have a greater action space than single mothers in the suburbs.

• The self-mapping technique enables respondents to visualize the extent of their physical movement and encourages dialogue among focus group participants in comparing activity spaces.

• Sharing results, including “coping stories”, with public transit officials is essential, due to the fact that low-income women are often invisible in larger O-D surveys.

• Future posibilities for research include using Quebec’s 2001 O-D survey of 27,000 households to validate accessibility challenges identified during the focus group discussions.

Involving youth in identifying perceptions of safe/unsafe spaces and the effects on their activity patterns in Providence, RI

(ongoing research: McCray, Atash, Collyer, Cunnigen)

Project Objectives

• Document the activity patterns of low-income & immigrant teenagers.

• Capture their perceptions of safe and unsafe areas in Providence and how these perceptions may influence activity patterns.

• Study and identify perceptions of “personal space” and patterns of aggressive behavior and violence in relation to modal use.

Research Questions

• What activities are common among low-income and immigrant teenagers, and to what degree do they use technology to shape their activity patterns?

• What value do students place on their spaces in relation to their homes and activity locations? How does this perception (safe/unsafe) compare to crime statistics in Providence?

• To what degree can nonviolence training sensitize students to becoming less violent, and more considerate of others in general, including behavior while riding the bus, driving a car, and socializing in public spaces?

Study Sample (data collection 9/2006 – 5/2007)

• Purposeful sample of Feinstein high school students (N=180) between the ages of 15-18.

Data Gathering Techniques

• Performing activity analysis. (surveys and activity lists)
• Performing qualitative and gender based spatial mapping of “perceived” safe/unsafe areas in the City of Providence.
• Conducting attitudinal surveys of “perceived” violence as it relates to interaction with others, driving, riding the bus, and walking.
• Exposing students to transportation professionals.
• Providing nonviolence training of students.
• Teaching students how to conduct an interview resulting in student-to-student interviews addressing teen culture.
• Providing GIS training to students.

References

Chapin, F. S. 1974. Human Activity Patterns in the City: Things people do in time and in space. New York: John Wiley and Sons, Inc.

Kane, E. (2003) Girls’ Education in Africa. Africa Region Human Development Working Paper Series, World Bank, Washington D.C.

McCray, T. & Brais, N. Exploring the role of transportation in social exclusion through the use of GIS to support qualitative data. Invited paper for a special issue in Networks and Spatial Economics (NETS), accepted, revised, waiting for 2007 publication date.

McCray, T.M. (2004) An issue of culture: the effects of daily activities on prenatal care utilization patterns in rural South Africa. Social Science and Medicine 59, 1843-1855.

Tanser, F., Hosegood, V., Benzler, J., & Solarsh, G. (2001). New approaches to spatially analyse primary health care usage patterns in rural South Africa. Tropical Medicine and International Health, 6(10), 826-838.