Transport Connectivity and Health Care Access: Evidence from Liberia

21 Pages Posted: 24 Apr 2018

See all articles by Atsushi Iimi

Atsushi Iimi

International Monetary Fund (IMF); World Bank

Kulwinder Singh Rao

World Bank Group

Date Written: April 18, 2018


Health care access is an important policy concern, especially in rural areas. It is especially challenging in developing countries, where rural residents are poorer and less likely to be insured than those living in urban areas. Using the case of Liberia, this paper examines the effects of transport connectivity on health care access. The Ebola crisis in 2014 and 2015 clearly revealed the vulnerability of the country's transport and health systems to unexpected external shocks. Paying particular attention to the possible challenge of endogeneity associated with infrastructure investment, the study found that transport connectivity, especially greater road density, can increase access to health care, but there was no significant effect of road quality. This may be because of significantly skewed underlying data. The vast majority of roads in Liberia are in poor condition. The study also found that the statistical effect of road density varies depending on distance from a health facility. The effect is particularly significant within a 30- to 50-kilometer radius. Not only rural accessibility, but also broader transport connectivity needs to be developed to increase health care access.

Keywords: Health Care Services Industry, Transport Services, Inequality, Health Service Management and Delivery

Suggested Citation

Iimi, Atsushi and Rao, Kulwinder Singh, Transport Connectivity and Health Care Access: Evidence from Liberia (April 18, 2018). World Bank Policy Research Working Paper No. 8413. Available at SSRN:

Atsushi Iimi (Contact Author)

International Monetary Fund (IMF)

700 19th Street, N.W.
Washington, DC 20431
United States

World Bank ( email )

1818 H Street NW
Washington, DC 20433
United States

Kulwinder Singh Rao

World Bank Group

10 Marina Boulevard
Marina Bay Financial Center, Tower 2, #34-02
Singapore, DC 018983

Register to save articles to
your library


Paper statistics

Abstract Views
PlumX Metrics