A key goal of urban transportation planning is to provide people with access to a greater number of opportunities for interaction with people and places. Measures of accessibility are gaining attention globally for use in planning, yet few studies measure accessibility in cities in low-income countries, and even fewer incorporate semi-formal bus systems, also called paratransit. Drawing on rich datasets available for Nairobi, Kenya this analysis quantifies place-based accessibility for walking, paratransit, and driving using three different measures: a mobility measure quantifying how many other locations in Nairobi can be reached in 60 min, a contour measure quantifying the number of health facilities that can be reached in 60 min, and a gravity measure quantifying the number of health facilities weighted by a time-decay function. Health facilities are used because they are an essential service that people need physical access to and as a representation of the spatial distribution of activities more broadly. The findings show that place-based accessibility is highest for driving, then paratransit, then walking, and that there are high levels of access to health facilities near the Central Business District (CBD) for all modes. Additionally, paratransit accessibility is comparatively better in the contour and gravity measures, which may mean that paratransit is efficiently providing access based on the spatial distribution of services. The contour measure results are also compared across different residential levels, which are grouped based on neighborhood characteristics and ordered by income. Counterintuitively, the wealthiest areas have very low levels of place-based accessibility for all modes, while poor areas have comparatively better walking access to health facilities. Interestingly, the medium low residential level, characterized in part by tenement apartment buildings, has significantly higher accessibility than other residential types. One way to reduce inequality in access across income groups is to increase spatial accessibility for the modes used by low- and middle-income households, for example with policies that prioritize public transport and non-motorized travel, integrate paratransit with land use development, and provide safe, efficient, and affordable options.
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