Inequality and access to social services in Latin America: space-time constraints of child health checkups and prenatal care in Montevideo

This paper explores the role of space-time constraints in determining the conditions under which people access to basic social services. To do so, the paper addresses two empirical questions: (i) how travel time impacts families' strategies for choosing and using social services, and (ii) how service characteristics become part of the constraints families have to face when using services. Both questions refer to problems that are of "time nature" (e.g., long waiting hours or the imposition of additional tasks and travel to finally obtain access to the service). The use of a space time approach introduces a theoretical innovation for studying access to urban public social services in the region, shedding light on the micro-processes underneath macro-aggregated indicators. This is performed by examining in a qualitative manner the way in which space time constraints are distributed among different types of families and by looking at families' strategies for accessing services in a city like Montevideo, the capital of Uruguay. The empirical evidence is a qualitative study with 13 households with at least one child between 0 and 3 years of age. These households were selected from a purposive sample that allowed the study of a group of cases from different socioeconomic strata living in different geographical locations. The paper results suggest that households use travel time as an input to manage total time investment (travel plus participation) when defining a strategy to reach better services. In addition, empirical evidence reflects the distorting effects that uncertainty about the time to be spent in using the services may have on the activities of households. (C) 2015 Elsevier Ltd. All rights reserved.