Geographic accessibility to primary healthcare centers in Mozambique
Geographic accessibility to primary healthcare centers in Mozambique
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DOI：
10.1186/s12939-016-0455-0
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发表时间：
2016-10-18
影响因子：
4.8
通讯作者：
Cabral, Pedro
中科院分区：
文献类型：
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作者：
Luis, Antonio dos Anjos;Cabral, Pedro
背景：获得医疗服务在促进健康公平和生活质量方面具有至关重要的作用。了解这些地方在哪里以及现有的医疗网络覆盖了多少人口是可以从地理信息系统(GIS)中提取并用于有效的医疗规划的重要信息。这项研究的目的是衡量人口对现有医疗中心(HC)的地理可达性，并估计莫桑比克医疗网络服务的人数。方法：利用卫生设施的位置以及人口、海拔和辅助数据，使用地理信息系统对HC的可达性进行建模。人们参加HC的两种出行时间情景被考虑：(1)驾车和；(2)步行。国家和省两级提供了服务的村庄和人口的估计，即距离社区中心60分钟内的村庄和人口，以及服务不足的地区，即距离社区中心60分钟以外的地区。结果：这项研究的结果突出了可达性问题，特别是在步行的情况下，90.2%的莫桑比克被认为是服务不足的地区。在这种情况下，马普托市(69.8%)是HC覆盖率最高的省份。另一方面，太特省(93.4%)、德尔加杜角省(93%)和加沙(92.8%)是服务不足地区最多的省份。驾驶场景的问题较小，莫桑比克约66.9%的地区被视为服务区。我们还发现，在这种情况下，各省的地区差距很大，从马普托市的100%覆盖率到德尔加杜角省的48.3%不等。在人口覆盖率方面，我们发现，步行方案的可及性问题更为严重，约67.3%的莫桑比克人口位于服务不足的地区。在驾驶场景中，只有6%的人口位于服务不足的地区。结论：本研究突出了莫桑比克以步行和驾车旅行时间距离评估HC缺乏的关键地区。在步行方案中，大多数莫桑比克人位于服务不足的地区。绘制的产出可能涉及政策问题，可用于今后的决策进程和分析。
Background: Access to healthcare services has an essential role in promoting health equity and quality of life. Knowing where the places are and how much of the population is covered by the existing healthcare network is important information that can be extracted from Geographical Information Systems (GIS) and used in effective healthcare planning. The aim of this study is to measure the geographic accessibility of population to existing Healthcare Centers (HC), and to estimate the number of persons served by the health network of Mozambique.Methods: Health facilities' locations together with population, elevation, and ancillary data were used to model accessibility to HC using GIS. Two travel time scenarios used by population to attend HC were considered: (1) Driving and; and (2) Walking. Estimates of the number of villages and people located in the region served, i. e. within 60 min from an HC, and underserved area, i. e. outside 60 min from an HC, are provided at national and province level.Results: The findings from this study highlight accessibility problems, especially in the walking scenario, in which 90.2 % of Mozambique was considered an underserved area. In this scenario, Maputo City (69.8 %) is the province with the greatest coverage of HC. On the other hand, Tete (93.4 %), Cabo Delgado (93 %) and Gaza (92.8 %) are the provinces with the most underserved areas. The driving scenario was less problematic, with about 66.9 % of Mozambique being considered a served area. We also found considerable regional disparities at the province level for this scenario, ranging from 100 % coverage in Maputo City to 48.3 % in Cabo Delgado. In terms of population coverage we found that the problem of accessibility is more acute in the walking scenario, in which about 67.3 % of the Mozambican population is located in underserved areas. For the driving scenario, only 6 % of population is located in underserved areas.Conclusions: This study highlights critical areas in Mozambique in which HC are lacking when assessed by walking and driving travel time distance. The majority of Mozambicans are located in underserved areas in the walking scenario. The mapped outputs may have policy implications and can be used for future decision making processes and analysis.