Labor & delivery unit closures most impact travel times to birth locations for micropolitan residents in Iowa

2022 ◽  
Author(s):  
Margaret Carrel ◽  
Barbara C. Keino ◽  
Kelli K. Ryckman ◽  
Stephanie Radke
Keyword(s):  
Travel Times ◽  
Delivery Unit

scholarly journals “In cities, it’s not far, but it takes long”: comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria

2021 ◽  
Vol 6 (1) ◽  
pp. e004318
Author(s):  
Aduragbemi Banke-Thomas ◽  
Kerry L M Wong ◽  
Francis Ifeanyi Ayomoh ◽  
Rokibat Olabisi Giwa-Ayedun ◽  
Lenka Benova
Keyword(s):  
Travel Time ◽  
Friction Surface ◽  
Obstetric Care ◽  
Travel Times ◽  
Night Time ◽  
Google Maps ◽  
Surface Approach ◽  
Low Resource ◽  
Life Saving ◽  
The Cost

BackgroundTravel time to comprehensive emergency obstetric care (CEmOC) facilities in low-resource settings is commonly estimated using modelling approaches. Our objective was to derive and compare estimates of travel time to reach CEmOC in an African megacity using models and web-based platforms against actual replication of travel.MethodsWe extracted data from patient files of all 732 pregnant women who presented in emergency in the four publicly owned tertiary CEmOC facilities in Lagos, Nigeria, between August 2018 and August 2019. For a systematically selected subsample of 385, we estimated travel time from their homes to the facility using the cost-friction surface approach, Open Source Routing Machine (OSRM) and Google Maps, and compared them to travel time by two independent drivers replicating women’s journeys. We estimated the percentage of women who reached the facilities within 60 and 120 min.ResultsThe median travel time for 385 women from the cost-friction surface approach, OSRM and Google Maps was 5, 11 and 40 min, respectively. The median actual drive time was 50–52 min. The mean errors were >45 min for the cost-friction surface approach and OSRM, and 14 min for Google Maps. The smallest differences between replicated and estimated travel times were seen for night-time journeys at weekends; largest errors were found for night-time journeys at weekdays and journeys above 120 min. Modelled estimates indicated that all participants were within 60 min of the destination CEmOC facility, yet journey replication showed that only 57% were, and 92% were within 120 min.ConclusionsExisting modelling methods underestimate actual travel time in low-resource megacities. Significant gaps in geographical access to life-saving health services like CEmOC must be urgently addressed, including in urban areas. Leveraging tools that generate ‘closer-to-reality’ estimates will be vital for service planning if universal health coverage targets are to be realised by 2030.

scholarly journals Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center

2020 ◽  
Vol 10 (03) ◽  
pp. e281-e287
Author(s):  
Sangeeta Kumaraswami ◽  
Tana S. Pradhan ◽  
Sorana Vrabie-Wolf ◽  
Sadaf Lodhi ◽  
Geetha P. Rajendran ◽  
...  
Keyword(s):  
New York ◽  
Care Center ◽  
Tertiary Care ◽  
New York State ◽  
York State Department ◽  
Obstetrical Care ◽  
Expert Opinions ◽  
Department Of Health ◽  
Delivery Unit ◽  
Westchester County

Abstract Objective To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges. Methods With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans. Results We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic. Conclusion The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York.

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