scholarly journals Spatial accessibility to basic public health services in South Sudan

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Peter M. Macharia ◽  
Paul O. Ouma ◽  
Ezekiel G. Gogo ◽  
Robert W. Snow ◽  
Abdisalan M. Noor
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Service Provider ◽  
Population Distribution ◽  
South Sudan ◽  
Civil Conflict ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Walking Distance ◽  
Health Access

At independence in 2011, South Sudan’s health sector was almost non-existent. The first national health strategic plan aimed to achieve an integrated health facility network that would mean that 70% of the population were within 5 km of a health service provider. Publically available data on functioning and closed health facilities, population distribution, road networks, land use and elevation were used to compute the fraction of the population within 1 hour walking distance of the nearest public health facility offering curative services. This metric was summarised for each of the 78 counties in South Sudan and compared with simpler metrics of the proportion of the population within 5 km of a health facility. In 2016, it is estimated that there were 1747 public health facilities, out of which 294 were non-functional in part due to the on-going civil conflict. Access to a service provider was poor with only 25.7% of the population living within one-hour walking time to a facility and 28.6% of the population within 5 km. These metrics, when applied sub-nationally, identified the same high priority, most vulnerable counties. Simple metrics based upon population distribution and location of facilities might be as valuable as more complex models of health access, where attribute data on travel routes are imperfect or incomplete and sparse. Disparities exist in South Sudan among counties and those with the poorest health access should be targeted for priority expansion of clinical services.

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 Changes in Pneumonia Incidence and Infant Mortality 5 Years Following Introduction of the 13-valent Pneumococcal Conjugate Vaccine in a “3+0” Schedule in Nicaragua

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S67-S68
Author(s):  
Sylvia Becker-Dreps ◽  
Bryan Blette ◽  
Rafaela Briceno ◽  
Jorge Aleman ◽  
Michael G Hudgens ◽  
...  
Keyword(s):  
Public Health ◽  
Infant Mortality ◽  
Bacterial Meningitis ◽  
Health Facility ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Public Health Intervention ◽  
Vital Statistics ◽  
Health Facilities ◽  
One Year

Abstract Background Streptococcus pneumoniae causes an estimated 826,000 deaths of children in the world each year and many health facility visits. To reduce the burden of pneumococcal disease, many nations have added pneumococcal conjugate vaccines to their national immunization schedules. Nicaragua was the first country eligible for funding from the GAVI Alliance to introduce the 13-valent pneumococcal conjugate vaccine (PCV13), provided to infants at 2, 4, and 6 months of age. The goal of this study was to evaluate the population impact of the first five years of the program. Methods Numbers of visits for pneumonia, pneumonia-related deaths, bacterial meningitis, and infant deaths between 2008 and 2015 were collected from all 107 public health facilities in León Department. Vital statistics data provided additional counts of pneumonia-related deaths that occurred outside health facilities. Adjusted incidence rates and incidence rate ratios (IRRa) in the vaccine (2011–2015) and pre-vaccine periods (2008–2010) were estimated using official population estimates as exposure time. Results The IRRa for pneumonia hospitalizations was 0.70 (95% confidence interval [CI]: 0.66, 0.75) for infants, and 0.92 (95% CI: 0.85, 0.99) for one year olds. The IRRa for post-neonatal infant mortality was 0.56 (95% CI: 0.41, 0.77). In the population as a whole, ambulatory visits and hospitalizations for pneumonia, as well as pneumonia-related mortality and rates of bacterial meningitis were lower in the vaccine period. Conclusion Five years following program introduction, reductions were observed in health facility visits for pneumonia in immunized age groups and infant mortality, which would be hard to achieve with any other single public health intervention. Future study is warranted to understand whether the lack of a booster dose (e.g.,, at 12 months) may be responsible for the small reductions in pneumonia hospitalizations observed in one year-olds as compared with infants. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; D. J. Weber, Pfizer: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N. Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

scholarly journals Geographical perspective of modeling primary healthcare accessibility

2017 ◽  
Vol 10 (1) ◽  
pp. 56-67 ◽  
Author(s):  
Justice Surage ◽  
Richard Tawiah ◽  
Timothy Twumasi-Mensah
Keyword(s):  
Health Facility ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Content Type ◽  
Central District ◽  
Healthcare Accessibility

Purpose The purpose of this paper is to measure the spatial accessibility of primary healthcare facility in Ghanaian rural areas, by determining the barriers to healthcare accessibilities in the Amansie Central District. Design/methodology/approach Both network and proximity analyses were performed on the digitized data such as road networks, settlements, population, district boundary, natural resources (rivers, streams and forest) and site location (health facilities). To quantify the population who have access to healthcare the authors used the Ghana Health Service access criteria that health facility should be accessible to an estimated population within 8 km radius from the facility. Findings The overall mean distance to the nearest health facility in the district was 8.9 km. Fiankoma sub-district recorded the highest mean distance whereas Tweapease sub-district recorded the least. In general, 31.2 percent of the district population has no access to healthcare facility. Transportation was identified to be one of the major hindrances to healthcare accessibility and this was as a result of poor road network in the district. Research limitations/implications The study was restricted to the Amansie Central District of Ghana. This limits the extent of generalization of results. Originality/value The study proposed additional sites for siting new health facilities base on criteria such as population, distance, centrality and existing infrastructural development. This will consequently improve healthcare accessibility and utilization by increasing total coverage closer to 100 percent.

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 GIS Application for Health Facility Coverage Mapping in Temanggung Regency, Central Java Province

2021 ◽  
Vol 5 (3) ◽  
pp. 160-173
Author(s):  
Arga Geofana
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Spatial Data ◽  
Road Network ◽  
Central Government ◽  
Public Health Facility ◽  
Health Facilities ◽  
Central Java ◽  
Topographic Condition ◽  
Central Java Province

Adequate health facilities have become one of the interesting issues to be discussed since this pandemic situation. Availability and accessibility of health facilities are the vital aspects that should be accomplished by both local and central government. Nevertheless, some population especially those living in rural areas have some difficulties in reaching these facilities due to the inequality condition within regions. This study aims to analyze the coverage of health facilities in Temanggung Regency, Central Java province and cluster its subdistricts according to their condition in accessing these facilities. The analysis is limited to public health facility (PUSKESMAS) and hospital levels. Both statistical and spatial data were processed using the GIS network analysis approach in producing the coverage number of each health facility and they were compared to the applied standard range of service and threshold. Then, a hierarchy is created using the weighted centrality index approach to represent disparities among subdistricts in Temanggung Regency regarding the availability and its coverage to health facilities. The results show that there is an inequality condition on health facilities coverage between central and peripheral areas within this regency, both at the public health facility level and hospital level. Several population in several districts, mostly residing in outer areas, are not covered by both public health facility and hospital. On the other hand, people in the capital and its surrounding subdistricts have better access to these facilities. Several factors are identified in producing this inequality, such as spatial distribution of housing areas, spatial allocation of health facilities, road network, and topographic condition. The topographic condition in some uncovered areas, which is relatively hilly and has steep slope, causes limited access to the road network and less coverage of health facilities.

scholarly journals Implementation of Tuberculosis Infection Control Practices in Tuberculosis Diagnostic and Treatment Health Facilities in Kampala District, Uganda, August 2015

2020 ◽  
Author(s):  
Didas Tugumisirize ◽  
Stavia Turyahabwe ◽  
Lilian Bulage ◽  
Stella Zawedde Muyanja ◽  
Robert Kaos Majwala ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Infection Control ◽  
Health Facility ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Tuberculosis Infection ◽  
Care Services ◽  
Tuberculosis Infection Control

AbstractBackgroundEffective implementation of Tuberculosis infection control (TB IC) measures in health facilities delivering TB care services is very critical in controlling nosocomial transmission of TB infections among health workers, patients and their attendants. The aim of the study was to assess and document the implementation of TB IC practices in TB diagnostic and treatment health facilities in Kampala District, which accounts for 15-20% of the total TB burden in Uganda.MethodsIn August 2015, we conducted a cross-sectional study in 25 health facilities including 07 Public and 18 Private healthcare facilities in Kampala. We used a modified checklist adopted from the national manual for implementing TB control measures in health care facilities. We reviewed health facility records and where necessary observed TB IC practices to triangulate our findings. We conducted univariate analysis and generated proportions in order to describe the extent of implementation of TB IC measures.ResultsOn average, 73% of both administrative and managerial, 65% environmental, and 56% personal protective TB IC measures were complied with at the health facilities visited. Private health facilities implemented 71% of both administrative and managerial TBIC measures compared to public health facilities (31%). Thirty Six percent of health facilities reported that they were regularly screening health care workers for TB. By Observation, 28% had TB IC guideline, 36% had TB IC plan, 12% had a designated area for sputum collection, 56% were regularly opening windows, 40% had fans installed in the waiting areas and/or consultation rooms and 24% had bio-safety cabinets fitted with UV light. In addition, 60% had N95 respirators but only 32% of the facilities reported that their health workers routinely wore them.ConclusionImplementation of WHO recommended TB IC measures in health facilities delivering TB care services in Kampala was sub optimal. Routine involvement of health facility management as well as increasing human resources for health is critical in implementing easy to do TBIC measures like triaging, patients’ educating on coughing etiquette and respiratory hygiene and daily window opening particularly in public health care settings where implementation of administrative TB IC measures is wanting

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to provide geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of key items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores with regard to; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher level HFs were statistically significantly friendlier than lower level HFs (p= 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p=0.025). Conclusion There is low readiness of public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for old people if the 2020 global healthy ageing goal is to be met.

scholarly journals Clients’ satisfaction with HIV care and treatment centres in Dar es Salaam, Tanzania: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247421
Author(s):  
Salome E. Buluba ◽  
Neema E. Mawi ◽  
Edith A. M. Tarimo
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Hiv Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care And Treatment ◽  
Hiv Aids

Background HIV is a major global public health challenge, claiming the lives of over 32 million people so far. The satisfaction of HIV-affected clients with the quality of their HIV services at treatment centres is crucial for quality improvement. This article assesses clients’ satisfaction with different aspects of the overall care experience and seeks to determine if the type of health facility ownership is a predictor of satisfaction. Methods A cross-sectional study involving 430 respondents was conducted between September and October 2019. Purposeful and convenient sampling techniques were used to select health facilities and potential respondents, respectively. A pre-tested, interviewer-administered questionnaire was used to collect data. Binary logistic regression was used to assess the association between type of health facility and clients’ satisfaction based on the six assessed aspects of care, and p˂0.05 was considered statistically significant. Results The general clients’ satisfaction with HIV/AIDS services at care and treatment centres was 92.3%. Respondents from public health facilities were most satisfied with privacy and confidentiality (100%), physical environment (100%), counseling (99.5%) and drug availability (99.5%); respondents from private health facilities were most satisfied with the time spent in the facility (95.9%); while respondents from faith-based health facilities were most satisfied with staff-patient communication (99.2%). However, after adjusting for confounders, only one aspect of care, that of “time spent in the facility,” showed significant association with the type of health facility. Conclusion Generally, clients’ satisfaction with HIV/AIDS services at care and treatment centres in the Ubungo District, Dar es Salaam was high. This finding should encourage health care providers to maintain high-quality services to sustain clients’ satisfaction.

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