Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh
Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh
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DOI：
10.1002/ijgo.12196
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发表时间：
2017-08-01
影响因子：
3.8
通讯作者：
Hossain, Mollah A.
中科院分区：
文献类型：
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作者：
Chowdhury, Mahbub E.;Biswas, Taposh K.;Hossain, Mollah A.
目标：使用地理信息系统 (GIS) 确定紧急产科和新生儿护理 (EmONC) 卫生设施的可及性，并将覆盖率与联合国指南规定的覆盖率进行比较（每 500000 人 5 个 EmONC 设施，1 个综合设施）。方法：对 2012 年 3 月至 10 月孟加拉国 24 个地区提供 EmONC 的所有公共设施进行横断面研究。通过应用 GIS 估计流域人口比例来评估每个设施的可及性（综合 500000；基本 100000）能够通过现有道路网络分别在 2 小时和 1 小时的行程时间内到达最近的设施。结果：提供综合和基本 EmONC 服务的公共设施的最低数量（分别为每 50 万人 1 个和 5 个）分别在 16 个和 3 个区达到。然而，应用 GIS 后，没有一个地区能够 100% 的流域人口获得这些服务。 11 个和 5 个地区分别有至少 75% 和 50% 的人口可以获得综合服务。对于基本服务，可及性要低得多。结论：仅评估 EmONC 设施的数量并不能确保全民覆盖；在规划卫生系统时应评估可达性。
Objective: To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500000 individuals, 1 comprehensive).Methods: A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500000; basic 100000) able to reach the nearest facility within 2hours and 1hour of travel time, respectively, by existing road networks.Results: The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower.Conclusion: Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems.