Modelling Geographic Accessibility of Primary Health Care Facilities in Bauchi Local Government Area
Abstract:
Achieving universal health care (UHC) coverage has been at the forefront of the United Nations (UN) agenda for 2030. Inequality in health care service provision continues to increase, hence militating against the achievement of reducing unequal access to health care. Access is a critical component of the healthcare delivery system that is impacted by both spatial and non-spatial elements. This study utilized health facilities, population, and other open-source data to analyze the distribution and spatial accessibility of healthcare service centers by using Geospatial technologies in the Bauchi Local Government Area of Bauchi State - Nigeria. Two traveling scenarios (Driving and Walking) were used to determine the travel time to the nearest health facilities, defined within a maximum of 30 minutes traveling time using AccessMod (Online) and ArcGIS Pro. It was found that 87% and 75% of the population are within 15 and 30 minutes of travel time by driving and walking, respectively, while 1.3% of the population are outside a 15 km radius of any health facility with a ratio of 1 to 4,454 population to a health facility. The result shows a significant spatial disparity in geographic accessibility and spatial coverage, with some parts of the rural areas not having access to the existing health facility network, regardless of the travel scenario chosen. This will offer an innovative approach to reducing gaps in healthcare access and subsequently enhance the efficient and effective delivery of healthcare services in low- and middle-income countries (LMIC) to achieve UHC.References:
[1] M. National Academies of Sciences, Engineering, H. and M. Division, B. on
P. H. and P. H. Practice, and C. on C.-B. S. to P. H. E. States, “The Root Causes
of Health Inequity,” Communities in Action: Pathways to Health Equity, pp. 1–558,
Jan. 2017, Doi: 10.17226/24624.
[2] O. Lawal and F. E. Anyiam, “Geo-spatial Information Science Modelling geographic
accessibility to Primary Health Care Facilities: combining open data and geospatial
analysis Modelling geographic accessibility to Primary Health Care Facilities: combining
open data and geospatial an,” Geo-spatial Information Science, vol. 22, no. 3, pp.
174–184, 2019, Doi: 10.1080/10095020.2019.1645508.
[3] A. S. Wigley, V. Alegana, A. Carioli, C. W. Ruktanonchai, C. Pezzulo, and
Z. Matthews, “Measuring the availability and geographical accessibility of maternal
health services across sub-Saharan Africa,” pp. 1–10, 2020.
[4] R. Penchansky and J. W. Thomas, “The concept of access: definition and relationship
to consumer satisfaction,” Medical care, vol. 19, no. 2, pp. 127–140, 1981, Doi:
10.1097/00005650-198102000-00001.
[5] M. E. Cyr, A. G. Etchin, B. J. Guthrie, and J. C. Benneyan, “Access to specialty
healthcare in urban versus rural US populations: A systematic literature review,”
BMC Health Services Research, vol. 19, no. 1, pp. 1–17, Dec. 2019, Doi: 10.1186/S12913-019-4815-5/FIGURES/4.
[6] W. H. Organization, “Gender, Equity, and Human Rights. Making a Difference:
Visions, Goals and Strategy,” World Health Organization, 2015.
[7] V. D. Pyrialakou, K. Gkritza, and J. D. Fricker, “Accessibility, mobility,
and realized travel behavior: Assessing transport disadvantage from a policy perspective,”
Journal of Transport Geography, vol. 51, pp. 252–269, 2016, Doi: https://Doi.org/10.1016/j.jtrangeo.2016.02.001.
[8] A. J. Comber, C. Brunsdon, and R. Radburn, “A spatial analysis of variations
in health access: linking geography, socio-economic status and access perceptions,”
International Journal of Health Geographics, vol. 10, no. 1, p. 44, 2011,
Doi: 10.1186/1476-072X-10-44.
[9] C. Li and J. Wang, “A hierarchical two-step floating catchment area analysis
for high-tier hospital accessibility in an urban agglomeration region,” Journal
of Transport Geography, vol. 102, Jun. 2022, Doi: 10.1016/j.jtrangeo.2022.103369.
[10] O. Lawal and F. E. Anyiam, “Modelling geographic accessibility to Primary
Health Care Facilities: combining open data and geospatial analysis,” http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=tgsi20#.
VsXpLiCLRhE, vol. 22, no. 3, pp. 174–184, 2019, Doi: 10.1080/10095020.2019.1645508.
[11] A. Al-Taiar, A. Clark, J. C. Longenecker, and C. J. M. Whitty, “Physical accessibility
and utilization of health services in Yemen,” International Journal of Health
Geographics, vol. 9, Jul. 2010, Doi: 10.1186/1476-072X-9-38.
[12] Steeve Ebener, Z. El Morjani, N. Ray, and M. Black, “Physical Accessibility
to health care: From Isotropy to Anisotropy,” Geospatial World, 2010. [Online].
Available: https://www.geospatialworld.net/article/physical-accessibility-to-health-care-from-isotropy-to-anisotropy/
[Accessed: 10-Nov-2022].
[13] M. F. Guagliardo, “Spatial accessibility of primary care: Concepts, methods
and challenges,” International Journal of Health Geographics, vol. 3, no.
1, pp. 1–13, Feb. 2004, Doi: 10.1186/1476-072X-3-3/FIGURES/3.
[14] R. K. Mallick and J. K. Routray, “Identification and accessibility analysis
of rural service centers in Kendrapara District, Orissa, India: a GIS-based application,”
International Journal of Applied Earth Observation and Geoinformation, vol.
3, no. 1, pp. 99–105, 2001, Doi: https://Doi.org/10.1016/S0303-2434(01)85027-3.
[15] S. L. McLafferty and L. Sara, “GIS and health care.,” Annual review of
public health, 2003, Doi: 10.1146/annurev.publhealth.24.012902.141012.
[16] R. Haining, “GIS and public health,” International Journal of Geographical
Information Science, vol. 27, no. 5, pp. 1040–1041, May 2013, Doi: 10.1080/13658816.2012.717629.
[17] A. M. Noor, P. W. Gikandi, S. I. Hay, R. O. Muga, and R. W. Snow, “Creating
spatially defined databases for equitable health service planning in low-income
countries: the example of Kenya.,” Acta tropic, vol. 91, no. 3, pp. 239–251, Aug.
2004, Doi: 10.1016/j.actatropica.2004.05.003.
[18] D. Buor, “Analysing the primacy of distance in the utilization of health services
in the Ahafo-Ano South district, Ghana.,” The International Journal of Health
Planning and Management, vol. 18, no. 4, pp. 293–311, 2003, Doi: 10.1002/hpm.729.
[19] D. R. Feikin et al., “The impact of distance of residence from a peripheral
health facility on pediatric health utilisation in rural western Kenya.,” Tropical
medicine & international health: TM & IH, vol. 14, no. 1, pp. 54–61,
Jan. 2009, Doi: 10.1111/j.1365-3156.2008.02193. x.
[20] J. E. Brustrom, “Going the distance: How far will women travel to undergo
free mammography?” Military Medicine, vol. 166, no. 4, pp. 347–349, 2001, Doi: 10.1093/milmed/166.4.347.
[21] M. Black, S. Ebener, P. N. Aguilar, M. Vidaurre, and Z. El Morjani, “Using
GIS to measure physical accessibility to health care Using GIS to Measure Physical
Accessibility to Health Care,” no. November 2004.
[22] W. Luo, “Using a GIS-based floating catchment method to assess areas with
a shortage of physicians,” Health and Place, vol. 10, no. 1, pp. 1–11, 2004, Doi:
10.1016/s1353-8292(02)00067-9.
[23] M. F. Dulin et al., “Using Geographic Information Systems (GIS) to understand
a community’s primary care needs.,” Journal of the American Board of Family Medicine:
JABFM, vol. 23, no. 1, pp. 13–21, 2010, Doi: 10.3122/jabfm.2010.01.090135.
[24] F. Parvin, S. A. Ali, S. N. I. Hashmi, and A. Khatoon, “Accessibility and
site suitability for healthcare services using GIS-based hybrid decision-making
approach: a study in Murshidabad, India.,” Spatial Information Research,
vol. 29, no. 1. pp. 1–18, 2021, Doi: 10.1007/s41324-020-00330-0.
[25] A. Dejen, S. Soni, and F. Semaw, “Spatial
accessibility analysis of healthcare service centers in Gamo Gofa Zone, Ethiopia
through Geospatial technique,” Remote Sensing Applications: Society and Environment,
vol. 13, pp. 466–473, Jan. 2019, Doi: 10.1016/J.RSASE.2019.01.004.
[26] R. L. J. Phillips, E. L. Kinman, P. G. Schnitzer, E. J. Lindbloom, and B.
Ewigman, “Using geographic information systems to understand health care access.,”
Archives of family medicine, vol. 9, no. 10, pp. 971–978, 2000, Doi: 10.1001/archfami.9.10.971.
[27] N. Khalil, “Primary Health Care Facilities in Kano,” vol. 3, no. 1, pp. 458–470,
2017.
[28] M. Abubakar, A. Abdulkadir, A. D. E.- yuguda, T. M. Hamisu, and S. S. Baba,
“Sero-Prevalence and Risk Factors Associated with Foot and MouthDisease in Bauchi
Local Government Area, Bauchi State Nigeria.,” IOSR Journal of Agriculture and Veterinary
Science, vol. 10, no. 06, pp. 56–61, Jun. 2017, Doi: 10.9790/2380-1006015661.
[29] WHO AccessMod, “AccessMod 5 | Modelling physical accessibility to health care,”
2017. [Online]. Available: https://www.accessmod.org/ [Accessed: 29-Nov-2022].
[30] Nigeria: National Primary Health Care Development Agenc, Ward minimum health
care package, 2007-2012. [Abuja, Nigeria: National Primary Health Care Development
Agency, 2007.
[31] W. Tobler, “Three presentations on geographical analysis and modeling: National
Center for Geographic Information and Analysis.,” no. February 1993.
[32] F. Hierink, N. Rodrigues, M. Muñiz, R. Panciera, and N. Ray, “Modelling geographical
accessibility to support disaster response and rehabilitation of a healthcare system:
an impact analysis of Cyclones Idai and Kenneth in Mozambique,” BMJ Open, vol. 10,
no. 11, p. e039138, Nov. 2020, Doi: 10.1136/BMJOPEN-2020-039138.
[33] A. dos Anjos Luis and P. Cabral, “Geographic accessibility to primary healthcare
centers in Mozambique,” International Journal for Equity in Health, vol.
15, no. 1, p. 173, 2016, Doi: 10.1186/s12939-016-0455-0.
[34] W. J. Ferguson, K. Kemp, and G. Kost, “Using a geographic information system
to enhance patient access to point-of-care diagnostics in a limited-resource setting,”
International Journal of Health Geographics, 2016, Doi: 10.1186/s12942-016-0037-9.
[35] A. Murad, “Using GIS for Determining
Variations in Health Access in Jeddah City, Saudi Arabia,” ISPRS International
Journal of Geo-Information 2018, Vol. 7, Page 254, vol. 7, no. 7, p. 254, Jun.
2018, Doi: 10.3390/IJGI7070254.
[36] W. H. O. (WHO), “Background paper for the technical consultation on effective
coverage of health systems, 27–29 August 2001, Rio de Janeiro, Brazil. Geneva: WHO;
2001.” 2018.
[37] C. Varela, S. Young, N. Mkandawire, R. S. Groen, L. Banza, and A. Viste, “Transportation
Barriers to Access Health Care for Surgical Conditions in Malawi a cross-sectional
nationwide household survey,” BMC Public Health, vol. 19, no. 1, pp. 1–8, Mar. 2019,
Doi: 10.1186/S12889-019-6577-8/TABLES/4.
[38] S. Mansour, “Spatial analysis of public health facilities in Riyadh Governorate,
Saudi Arabia: a GIS-based study to assess geographic variations of service provision
and accessibility,” Geo-spatial Information Science, vol. 19, no. 1, pp. 26–38,
Jan. 2016, Doi: 10.1080/10095020.2016.1151205.
[39] O. Kotavaara, A. Nivala, T. Lankila, T. Huotari, E. Delmelle, and H. Antikainen,
“Geographical accessibility to primary health care in Finland – Grid-based multimodal
assessment,” Applied Geography, vol. 136, p. 102583, Nov. 2021, Doi: 10.1016/J.APGEOG.2021.102583.
[40] M. Bello, “A Robust Approach to Determining Under-served Settlements for Health
Using Geographic and Spatial Coverage Modelling in Bauchi Local Government Area,”
Texila International Journal of Public Health, vol. 10, no. 2, pp. 196–207,
2022, Doi: 10.21522/tijph.2013.10.02.art017.
[41] C. Moïsi et al., “Geographic access to care is not a determinant of child
mortality in a rural Kenyan setting with high health facility density,” BMC Public
Health, vol. 10, no. 1, pp. 1–9, 2010.
[42] N. Ray and S. Ebener, “AccessMod 3.0: computing geographic coverage and accessibility
to health care services using anisotropic movement of patients,” International
Journal of Health Geographics, vol. 7, no. 1, p. 63, 2008, Doi: 10.1186/1476-072X-7-63.
[43] R. Haynes, A. P. Jones, V. Sauerzapf, and H. Zhao, “Validation of travel times
to hospital estimated by GIS.,” International journal of health geographics,
vol. 5, p. 40, Sep. 2006, Doi: 10.1186/1476-072X-5-40.