Gender inequality, transport, and wellbeing: The case of child healthcare in Uruguay

This paper addresses how transport-related factors and health service provision negatively impacts women's wellbeing and healthcare accessibility. It analyzes space-time costs for the transport component but also those resulting from healthcare quality provision. In particular, it focused on the role played by gender inequality in the distribution of space-time costs related to accessing healthcare for young children in Montevideo, Uruguay's capital city. We use a mixed-methods approach, with quantitative indicators and qualitative information to analyze the mechanisms that translate space-time costs into obstacles to access healthcare and women's wellbeing. We build on a survey of 409 individuals in healthcare facilities using a random multistage design to select the sample. We also carried out 30 in-depth interviews with users from low, middle, and high-income sectors. We find that taking children to health checkups is women's work. In 3 out of 4 cases, the mother is present at the clinic with the child. Male presence is relatively infrequent and is associated with travel by car to the healthcare facility. Women tend to travel longer and spend more time carrying out the activity. They also have to wait longer once they reach the clinic. Women naturalize this fact in their narratives. We call attention to the need for an integrated approach to study the relationship between transport and women's wellbeing. The case study illustrates that conventional sectorial perspectives may overlook potential severe threats to women's wellbeing. Even with high-quality transport systems, these costs could persist if the quality of healthcare provision forces women to endure waiting time uncertainty and forego significant activities in their daily lives. • Space-time costs in access to children's healthcare are mostly faced by women. • Travel and waiting time have a negative impact of women's personal and emotional wellbeing. • Women naturalize space-time costs in their daily lives.