scholarly journals Estimating the Spatial Accessibility to Blood Group and Rhesus Type Point-of-Care Testing for Maternal Healthcare in Ghana

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 175 ◽  
Author(s):  
Desmond Kuupiel ◽  
Kwame M. Adu ◽  
Vitalis Bawontuo ◽  
Duncan A. Adogboba ◽  
Tivani P. Mashamba-Thompson
Keyword(s):  
Travel Time ◽  
Blood Group ◽  
Spatial Data ◽  
Point Of Care ◽  
Health Facilities ◽  
Public Hospitals ◽  
Spatial Accessibility ◽  
Maternal Healthcare ◽  
Medical Laboratories ◽  
Health Centres

Background: In Ghana, a blood group and rhesus type test is one of the essential recommended screening tests for women during antenatal care since blood transfusion is a key intervention for haemorrhage. We estimated the spatial accessibility to health facilities for blood group and type point-of-care (POC) testing in the Upper East Region (UER), Ghana. Methods: We assembled the attributes and spatial data of hospitals, clinics, and medical laboratories providing blood group and rhesus type POC testing in the UER. We also obtained the spatial data of all the 131 towns, and 94 health centres and community-based health planning and services (CHPS) compounds providing maternal healthcare in the region. We further obtained the topographical data of the region, and travel time estimated using an assumed tricycle speed of 20 km/h. We employed ArcGIS 10.5 to estimate the distance and travel time and locations with poor spatial access identified for priority improvement. Findings: In all, blood group and rhesus type POC testing was available in 18 health facilities comprising eight public hospitals and six health centres, one private hospital, and three medical laboratories used as referral points by neighbouring health centres and CHPS compounds without the service. Of the 94 health centres and CHPS compounds, 51.1% (48/94) and 66.4% (87/131) of the towns were within a 10 km range to a facility providing blood group and rhesus type testing service. The estimated mean distance to a health facility for blood group and rhesus POC testing was 8.9 ± 4.1 km, whilst the mean travel time was 17.8 ± 8.3 min. Builsa South district recorded the longest mean distance (25.6 ± 7.4 km), whilst Bongo district recorded the shortest (3.1 ± 1.9 km). The spatial autocorrelation results showed the health facilities providing blood group and rhesus type POC testing were randomly distributed in the region (Moran Index = 0.29; z-score = 1.37; p = 0.17). Conclusion: This study enabled the identification of district variations in spatial accessibility to blood group and rhesus type POC testing in the region for policy decisions. We urge the health authorities in Ghana to evaluate and implement recommended POC tests such as slide agglutination tests for blood group and rhesus type testing in resource-limited settings.

scholarly journals Geographical access to point-of-care testing for hypertensive disorders of pregnancy as an integral part of maternal healthcare in Ghana

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Desmond Kuupiel ◽  
Kwame Manu Adu ◽  
Vitalis Bawontuo ◽  
Philip T. N. Tabong ◽  
Duncan A. Adogboba ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Point Of Care ◽  
Health Planning ◽  
Public Hospitals ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Healthcare ◽  
Community Based ◽  
Hypertensive Disorders ◽  
Physical Accessibility

Abstract Background Hypertensive disorders of pregnancy (HDP) are associated with high maternal mortality in Ghana and globally. Evidence shows that there is poor availability of pregnancy-related point-of-care (POC) tests in Ghana’s primary healthcare (PHC) clinics (health centre or community-based health planning services facilities). Therefore, we employed geographic information systems to estimate the geographical distribution of and physical accessibility to HDP POC testing services in the Upper East Region (UER), Ghana. Methods We collected data on 100 out of 365 PHC clinics, public hospitals providing HDP testing, PHC clinic type, ownership, and availability of urine dipsticks and blood pressure (BP) devices. We also obtained the geo-located data of the PHC clinics and hospitals using the global positioning system. We employed ArcGIS 10.4 to measure the distance and travel time from the location of each PHC clinic without HDP POC testing services as well as from all locations of each district to the nearest hospital/clinic where the service is available. The travel time was estimated using an assumed motorised tricycle speed of 20 km/hour. We further calculated the spatial distribution of the hospitals/clinics providing HDP POC testing services using the spatial autocorrelation tool in ArcMap, and Stata version 14 for descriptive statistical analysis. Results Of the 100 participating PHC clinics, POC testing for HDP was available in 19% (14% health centres and 5% community-based health planning services compounds) in addition to the 10 hospitals use as referral points for the service. The findings indicated that the spatial pattern of the distribution of the health facilities providing HDP POC testing was random (z-score = -0.61; p = 0.54). About 17% of the PHC clinics without HDP POC testing service were located > 10 km to the nearest facility offering the service. The mean distance and travel time from PHC clinics without HDP POC testing to a health facility providing the service were 11.4 ± 9.9 km and 31.1 ± 29.2 min respectively. The results suggest that if every 19% of the 365 PHC clinics are offering HDP POC testing in addition to these 10 hospitals identified, then the estimated coverage (health facility-to-women in fertility age ratio) in the UER is 1: 3,869. Conclusions There is poor physical accessibility to HDP POC testing services from PHC clinics without HDP POC testing in the UER. Mothers who obtain maternal healthcare in about 17% of the PHC clinics travel long distances (> 10 km) to access the service when needed. Hence, there is a need to improve the availability of HDP POC diagnostic tests in Ghana’s rural clinics.

scholarly journals Spatial access inequities and childhood immunisation uptake in Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Noel K. Joseph ◽  
Peter M. Macharia ◽  
Paul O. Ouma ◽  
Jeremiah Mumo ◽  
Rose Jalang’o ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Total Population ◽  
Univariate Analysis ◽  
Household Wealth ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Major Barrier

Abstract Background Poor access to immunisation services remains a major barrier to achieving equity and expanding vaccination coverage in many sub-Saharan African countries. In Kenya, the extent to which spatial access affects immunisation coverage is not well understood. The aim of this study was to quantify spatial accessibility to immunising health facilities and determine its influence on immunisation uptake in Kenya while controlling for potential confounders. Methods Spatial databases of immunising facilities, road network, land use and elevation were used within a cost friction algorithim to estimate the travel time to immunising health facilities. Two travel scenarios were evaluated; (1) Walking only and (2) Optimistic scenario combining walking and motorized transport. Mean travel time to health facilities and proportions of the total population living within 1-h to the nearest immunising health facility were computed. Data from a nationally representative cross-sectional survey (KDHS 2014), was used to estimate the effect of mean travel time at survey cluster units for both fully immunised status and third dose of diphtheria-tetanus-pertussis (DPT3) vaccine using multi-level logistic regression models. Results Nationally, the mean travel time to immunising health facilities was 63 and 40 min using the walking and the optimistic travel scenarios respectively. Seventy five percent of the total population were within one-hour of walking to an immunising health facility while 93% were within one-hour considering the optimistic scenario. There were substantial variations across the country with 62%(29/47) and 34%(16/47) of the counties with < 90% of the population within one-hour from an immunising health facility using scenarios 1 and 2 respectively. Travel times > 1-h were significantly associated with low immunisation coverage in the univariate analysis for both fully immunised status and DPT3 vaccine. Children living more than 2-h were significantly less likely to be fully immunised [AOR:0.56(0.33–0.94) and receive DPT3 [AOR:0.51(0.21–0.92) after controlling for household wealth, mother’s highest education level, parity and urban/rural residence. Conclusion Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya.

scholarly journals Determining Variations in Access to Public Hospitals in Makkah, Kingdom of Saudi Arabia: A GIS-Based Approach

2021 ◽  
Vol 1 (1) ◽  
pp. 26-32
Author(s):  
Mazen Baazeem ◽  
Marc Tennant ◽  
Estie Kruger
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Urban Areas ◽  
Population Distribution ◽  
Health Facilities ◽  
Public Hospitals ◽  
Spatial Accessibility ◽  
Geographical Information ◽  
Health Coverage ◽  
Gis Technology

Background: Variation in gaining accessibility to public hospitals in Makkah, Saudi Arabia, has not been investigated before. Good access to public health facility will lead to improvements in the population’s health. Maps and geographical information system (GIS) technology can provide assistance to address public health coverage issues. Aims: This study aimed to use GISs to identify spatial accessibility to hospitals in Makkah, based on the radius and drive-time analysis technique. Method: Using Quantum GIS (QGIS), a geodatabase was created to include 8 public hospitals’ locations and data of population distribution across the city. Buffer zones at 2.5, 5, 7, and 10 km radius from the public hospitals were identified and examined. Results: The findings revealed that most of the health facilities across the suburbs of Makkah were located in urban areas, while rural and remote areas were neglected. Conclusion: Public health facilities were distributed relative to high population density. One-third of the city’s population does not have proper access to healthcare services.

scholarly journals Pentavalent Vaccination in Rural Kenya: Coverage and Geographical Accessibility to Health Facilities Using Data from a Community Demographic and Health Surveillance System in Kilifi County.

2020 ◽  
Author(s):  
Morris Ogero ◽  
James Orwa ◽  
Rachael Odhiambo ◽  
Felix Agoi ◽  
Adelaide Lusambili ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Routine Immunisation

Abstract BackgroundThere is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.MethodsCoordinates of health facilities, information on land cover, digital elevation models, and road networks were used to compute spatial accessibility to immunizing health facilities for eligible children within the Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of travel time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other a priori identified confounding factors.ResultsSpatial access to health facilities that offer immunization services significantly affected DTP3 coverage, with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).ConclusionIncreased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high-resolution maps to identify areas where distance and travel time may impede the achievement of high immunization coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county.

scholarly journals EQUITABLE ACCESS TO HEALTH SERVICE IN BANYUWANGI

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Lusi Herawati Sunyoto Usman Mark Zuidgeest
Keyword(s):  
Health Service ◽  
Travel Time ◽  
Health Facilities ◽  
Public Hospitals ◽  
Health Centers ◽  
Equitable Access ◽  
Access To Health ◽  
Poor Group ◽  
Transport Modes ◽  
The Government

Equitable health care is a basic right for citizens and must be fulfilled by the government. This research analyzed communitydiscrepancy in access to reach health services in public hospitals and Puskesmas (health centers) in Banyuwangi Regency.This research identified community accessibility to health facilities services using travel time and transport modes choiceas indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.

scholarly journals Modelling Potential Geographical Access of the Population to Public Hospitals and Quality Health Care in Romania

2020 ◽  
Vol 17 (22) ◽  
pp. 8487
Author(s):  
Liliana Dumitrache ◽  
Mariana Nae ◽  
Gabriel Simion ◽  
Ana-Maria Taloș
Keyword(s):  
Health Care ◽  
Health Services ◽  
Travel Time ◽  
Population Distribution ◽  
Care Delivery ◽  
Public Hospitals ◽  
Spatial Accessibility ◽  
Quality Health Care ◽  
Geographical Access ◽  
Quality Health

The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service from Google Maps and open data sources. Based on real-time traffic navigation data, we examined the potential accessibility of hospitals through a weighted model that took into account the hospital competency level and travel time while using personal car transportation mode. Two scenarios were generated that depend on hospitals’ level of competency (I–V). When considering all categories of hospitals, access is relatively good with over 80% of the population reaching hospitals in less than 30 min. This is much lower in the case of hospitals that provide complex care, with 34% of the population travelling between 90 to 120 min to the nearest hospital classed in the first or second category of competence. The index of spatial accessibility (ISA), calculated as a function of real travel time and level of competency of the hospitals, shows spatial patterns of services access that highlight regional disparities or critical areas. The high concentration of infrastructure and specialised medical personnel in particular regions and large cities limits the access of a large part of the population to quality health services with travel time and distances exceeding optimal European level values. The results can help decision-makers to optimise the location of health services and improve health care delivery.

scholarly journals Pentavalent vaccination in rural Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County.

2020 ◽  
Author(s):  
Morris Ogero ◽  
James Orwa ◽  
Rachael Odhiambo ◽  
Felix Agoi ◽  
Adelaide Lusambili ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Road Network ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Routine Immunisation

Abstract Background There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children, because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore of its effect on immunisation coverage in one of the predominantly rural counties in the coast of Kenya.Methods Coordinates of health facilities, information on land cover, digital elevation model, and road network were used to compute spatial accessibility to immunising health facilities for eligible children within Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of the travel-time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other apriori identified confounding factors. Results Spatial access to health facilities that offer immunization services significantly affected DTP3 coverage with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).Conclusion Increased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high resolution maps to identify areas where distance and travel time may impede achievement of high immunizations coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard to reach areas within the county.

scholarly journals Pentavalent vaccination in rural Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County.

2020 ◽  
Author(s):  
Morris Ogero ◽  
James Orwa ◽  
Rachael Odhiambo ◽  
Felix Agoi ◽  
Adelaide Lusambili ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Routine Immunisation

Abstract BackgroundThere is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.MethodsCoordinates of health facilities, information on land cover, digital elevation models, and road networks were used to compute spatial accessibility to immunizing health facilities for eligible children within the Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of travel time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other a priori identified confounding factors.ResultsSpatial access to health facilities that offer immunization services significantly affected DTP3 coverage, with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).ConclusionIncreased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high-resolution maps to identify areas where distance and travel time may impede the achievement of high immunization coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county.

Exploration of Mothers’ Expectations of Care during Childbirth in Public Health Facilities in Kumasi, Ghana

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Dzomeku ◽  
Brian Van Wyk ◽  
Lucia Knight ◽  
Jody R. Lori
Keyword(s):  
Public Health ◽  
Clinical Care ◽  
Health Facilities ◽  
Individual Interviews ◽  
Midwifery Education ◽  
Health Centres ◽  
Adequate Communication ◽  
Safe Care ◽  
Respectful Care ◽  
Childbirth Care

It is well established that clients’ past healthcare experiences influence their further use of that particular service, as well as their recommendations of that service. This also applies to the use of facility-based childbirth services which contribute to reducing maternal and infant mortality rates. This paper explores what mothers’ want from care in public health centres during childbirth. Knowing mothers’ expectations will contribute to improving their future childbirth care experiences. In this explorative qualitative study, 56 women were recruited from four public health centres. In-depth individual interviews were digitally recorded and transcribed in full, and subjected to content analysis. Themes emerged, revealing participants’ desire for both “respectful care” and “safe care”. From our findings, we posit that respectful care should be characterised by adequate communication between the healthcare provider and patient, and involvement of the patient in care decisions. Participants expected safe care, which results from health facilities with adequate resources. Health services generally concentrate on clinical care which aligns with mothers’ expectations of respectful and safe care. However, soft skills need much attention in nursing and midwifery education. There is also a need to orient midwives to a patient-centred approach to care that meets mothers’ expectations for childbirth care.

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