Physical accessibility and utilization of health services in Yemen
Physical accessibility and utilization of health services in Yemen
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DOI：
10.1186/1476-072x-9-38
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发表时间：
2010-07-21
影响因子：
4.9
通讯作者：
Whitty, Christopher J. M.
中科院分区：
文献类型：
--
作者：
Al-Taiar, Abdullah;Clark, Allan;Whitty, Christopher J. M.
背景：评估卫生服务的实际可及性对规划极为重要。在工业化国家，采用综合道路网络和运输系统数据输入的复杂方法来评估实际获得医疗保健的机会。然而，在许多发展中国家几乎不存在这种数据输入。服务提供者和常住人口之间的直线距离很容易获得，但它们与驾驶距离和旅行时间的关系尚不清楚。本研究旨在探讨不同的物理访问措施，包括直线距离，道路距离和旅行时间和这些措施对儿童的疫苗接种在Yemen.Methods的影响之间的关系：房屋和卫生设施的坐标由GPS机确定在塔伊兹省，也门的城市和农村地区。道路距离是通过车辆里程表测量的，车辆从参与者的住宅行驶到最近的保健中心。使用秒表测量行驶时间。结果：直线距离、驾车距离、驾车时间与儿童预防接种相关性较强直线距离与行驶距离r = 0.92，p < 0.001，直线距离与行驶时间r = 0.75; p < 0.001，行驶距离与行驶时间r = 0.83，p < 0.001）。每一个措施的物理访问显示出很强的关联性调整后的儿童接种疫苗的社会经济地位。结论：直线距离，驾驶距离和驾驶时间有很强的联系，并与疫苗接种率。直线距离可用于评估缺乏道路网和交通数据投入的地区实际获得保健服务的情况。在也门，实际获取的影响是明显的，这突出表明需要努力针对远离卫生设施的儿童采取疫苗接种和其他预防性保健措施。
Background: Assessment of physical access to health services is extremely important for planning. Complex methods that incorporate data inputs from road networks and transport systems are used to assess physical access to healthcare in industrialised countries. However, such data inputs hardly exist in many developing countries. Straight-line distances between the service provider and resident population are easily obtained but their relationship with driving distance and travel time is unclear. This study aimed to investigate the relationship between different measures of physical access, including straight-line distances, road distances and travel time and the impact of these measures on the vaccination of children in Yemen.Methods: Coordinates of houses and health facilities were determined by GPS machine in Urban and rural areas in Taiz province, Yemen. Road distances were measured by an odometer of a vehicle driven from participants' houses to the nearest health centre. Driving time was measured using a stop-watch. Data on children's vaccination were collected by personal interview and verified by inspecting vaccination cards.Results: There was a strong correlation between straight-line distances, driving distances and driving time (straight line distances vs. driving distance r = 0.92, p < 0.001, straight line distances vs. driving time r = 0.75; p < 0.001, driving distance vs. driving time r = 0.83, p < 0.001). Each measure of physical accessibility showed strong association with vaccination of children after adjusting for socio-economic status.Conclusion: Straight-line distances, driving distances and driving time are strongly linked and associated with vaccination uptake. Straight-line distances can be used to assess physical access to health services where data inputs on road networks and transport are lacking. Impact of physical access is clear in Yemen, highlighting the need for efforts to target vaccination and other preventive healthcare measures to children who live away from health facilities.