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Spatial Accessibility, Institutional Delivery and Timely Initiation of Breastfeeding: Evidence from Four Sub-Saharan African Countries

Zhang, Lin LU (2026) EKHS02 20261
Department of Economic History
Abstract
This thesis examines the relationship between spatial accessibility, institutional delivery and timely initiation of breastfeeding in Nigeria, Ghana, Tanzania and Zambia. It uses recent DHS data combined with OpenStreetMap data on health facilities and roads to construct spatial accessibility measures, including distance to the nearest health facility, distance to major roads and combined accessibility typologies. Logit models are used to analyse two questions: whether spatial accessibility is associated with institutional delivery, and whether place of delivery is associated with breastfeeding initiation within one hour after birth. The results show that spatial accessibility is associated with institutional delivery in all four... (More)
This thesis examines the relationship between spatial accessibility, institutional delivery and timely initiation of breastfeeding in Nigeria, Ghana, Tanzania and Zambia. It uses recent DHS data combined with OpenStreetMap data on health facilities and roads to construct spatial accessibility measures, including distance to the nearest health facility, distance to major roads and combined accessibility typologies. Logit models are used to analyse two questions: whether spatial accessibility is associated with institutional delivery, and whether place of delivery is associated with breastfeeding initiation within one hour after birth. The results show that spatial accessibility is associated with institutional delivery in all four countries, but the spatial dimension most strongly associated with delivery differs across contexts. Institutional delivery is positively associated with EIBF in all four countries, whereas caesarean section is negatively associated with EIBF. Together, the country-specific associations are consistent with the proposed service-use pathway. (Less)
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author
Zhang, Lin LU
supervisor
organization
course
EKHS02 20261
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Spatial accessibility, Institutional delivery, Breastfeeding, Caesarean, DHS
language
English
id
9249138
date added to LUP
2026-09-07 12:29:12
date last changed
2026-09-07 12:29:12
@misc{9249138,
  abstract     = {{This thesis examines the relationship between spatial accessibility, institutional delivery and timely initiation of breastfeeding in Nigeria, Ghana, Tanzania and Zambia. It uses recent DHS data combined with OpenStreetMap data on health facilities and roads to construct spatial accessibility measures, including distance to the nearest health facility, distance to major roads and combined accessibility typologies. Logit models are used to analyse two questions: whether spatial accessibility is associated with institutional delivery, and whether place of delivery is associated with breastfeeding initiation within one hour after birth. The results show that spatial accessibility is associated with institutional delivery in all four countries, but the spatial dimension most strongly associated with delivery differs across contexts. Institutional delivery is positively associated with EIBF in all four countries, whereas caesarean section is negatively associated with EIBF. Together, the country-specific associations are consistent with the proposed service-use pathway.}},
  author       = {{Zhang, Lin}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{Spatial Accessibility, Institutional Delivery and Timely Initiation of Breastfeeding: Evidence from Four Sub-Saharan African Countries}},
  year         = {{2026}},
}