Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data

Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data Christina Mergenthaler, John Ifejube, Peter Stephens, Umar Saif, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7926116/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Geographical distance is an important dimension of access to healthcare and is considered in a wide range of settings to aid strategic planning and evaluation of healthcare interventions. Evidence has shown that in addition to geographic distance, multiple factors influence the travel behavior of people seeking health services. Yet most studies have largely framed the issue from the perspective of how far people should travel, while few have explained how far people actually travel, thereby overlooking potential insights into travel behaviors. In this research, we used in-person interviews, telecom mobility data, and spatial analysis to estimate peoples’ accessibility to TB service points in Pakistan. Characteristics of TB service points, including urbanicity, socioeconomic class, and administrative province were further analysed for their association with TB service accessibility. We compared the accessibility rates obtained from in-person interviews among people visiting TB service points with telecom mobility data to assess whether measured population movements to TB service points differ by data source. Our results show that significant variations in TB service accessibility are associated with administrative provinces, and the density of TB service points. We found a significant difference between the geographic accessibility measured by the two data sources across distance bands. We also found that relative, and not absolute, TB service accessibility is similar across both data sources, with a steeper decay curve in the interview data. While telecom mobility data and survey data capture different population movement patterns, both provide insights which may help to align service availability with population needs. Full Text Additional Declarations Competing interest reported. IQVIA: Yee Theng Ng and Razi Syed are employed by IQVIA SOLUTIONS ASIA PTE LTD and IQVIA SOLUTIONS PAKISTAN (PVT) LTD respectively, which provide proprietary pharmaceutical sales data on a commercial basis. AiSight.ai: Dr. Umar Saif and Bilal Butt work at aiSight.ai, which provides proprietary data analytical services on a commercial basis. Supplementary Files IQVIAAccessAnalysisManuscriptSupplementaryFile1.docx IQVIAAccessAnalysisManuscriptSupplementaryFile2.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 28 Jan, 2026 Reviews received at journal 26 Jan, 2026 Reviewers agreed at journal 19 Jan, 2026 Reviews received at journal 29 Dec, 2025 Reviews received at journal 27 Dec, 2025 Reviewers agreed at journal 14 Dec, 2025 Reviewers agreed at journal 14 Dec, 2025 Reviewers agreed at journal 11 Dec, 2025 Reviewers invited by journal 14 Nov, 2025 Editor invited by journal 07 Nov, 2025 Editor assigned by journal 23 Oct, 2025 Submission checks completed at journal 23 Oct, 2025 First submitted to journal 22 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7926116","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":549827195,"identity":"532c00a2-6360-4a6f-8f85-fac016d097d7","order_by":0,"name":"Christina 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IQVIA: Yee Theng Ng and Razi Syed are employed by IQVIA SOLUTIONS ASIA PTE LTD and IQVIA SOLUTIONS PAKISTAN (PVT) LTD respectively, which provide proprietary pharmaceutical sales data on a commercial basis.\n\nAiSight.ai: Dr. Umar Saif and Bilal Butt work at aiSight.ai, which provides proprietary data analytical services on a commercial basis.","formattedTitle":"Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-global-and-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Global and Public Health](https://bmcglobalpublichealth.biomedcentral.com/)","snPcode":"44263","submissionUrl":"https://submission.springernature.com/new-submission/44263/3","title":"BMC Global and Public Health","twitterHandle":"@BMC_GPH","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7926116/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7926116/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eGeographical distance is an important dimension of access to healthcare and is considered in a wide range of settings to aid strategic planning and evaluation of healthcare interventions. Evidence has shown that in addition to geographic distance, multiple factors influence the travel behavior of people seeking health services. Yet most studies have largely framed the issue from the perspective of how far people should travel, while few have explained how far people actually travel, thereby overlooking potential insights into travel behaviors. In this research, we used in-person interviews, telecom mobility data, and spatial analysis to estimate peoples\u0026rsquo; accessibility to TB service points in Pakistan. Characteristics of TB service points, including urbanicity, socioeconomic class, and administrative province were further analysed for their association with TB service accessibility. We compared the accessibility rates obtained from in-person interviews among people visiting TB service points with telecom mobility data to assess whether measured population movements to TB service points differ by data source. Our results show that significant variations in TB service accessibility are associated with administrative provinces, and the density of TB service points. We found a significant difference between the geographic accessibility measured by the two data sources across distance bands. We also found that relative, and not absolute, TB service accessibility is similar across both data sources, with a steeper decay curve in the interview data. While telecom mobility data and survey data capture different population movement patterns, both provide insights which may help to align service availability with population needs.\u003c/p\u003e","manuscriptTitle":"Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-25 20:17:20","doi":"10.21203/rs.3.rs-7926116/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-28T16:20:15+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-26T11:54:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"93146349783735678431250434153420460480","date":"2026-01-19T10:16:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-29T16:38:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-28T02:52:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"7792955798688591323663601878191255145","date":"2025-12-15T04:45:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"14767602002302498842793927258659378320","date":"2025-12-14T17:14:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"326297365457471459910548464028062597501","date":"2025-12-11T14:45:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-14T10:31:44+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-07T10:51:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-23T07:48:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-23T07:42:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Global and Public Health","date":"2025-10-22T18:33:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-global-and-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Global and Public Health](https://bmcglobalpublichealth.biomedcentral.com/)","snPcode":"44263","submissionUrl":"https://submission.springernature.com/new-submission/44263/3","title":"BMC Global and Public Health","twitterHandle":"@BMC_GPH","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aeceb62a-f1c3-4033-a7da-394265a7f2e7","owner":[],"postedDate":"November 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T12:53:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-25 20:17:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7926116","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7926116","identity":"rs-7926116","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}