"In cities, it's not far, but it takes long": comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria.
"In cities, it's not far, but it takes long": comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria.
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DOI：
10.1136/bmjgh-2020-004318
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发表时间：
2021-01
影响因子：
8.1
通讯作者：
Benova L
中科院分区：
文献类型：
--
作者：
Banke-Thomas A;Wong KLM;Ayomoh FI;Giwa-Ayedun RO;Benova L
在低资源环境中，前往综合产科急诊护理设施的旅行时间通常使用建模方法进行估计。我们的目标是利用模型和网络平台与实际的旅行复制，得出并比较到达非洲大城市CEMEC的旅行时间估计数。我们从2018年8月至2019年8月期间在拉各斯，尼日利亚的四个公有三级CEmOC设施中紧急就诊的所有732名孕妇的患者档案中提取了数据。对于一个系统选择的子样本385，我们估计旅行时间从他们的家到设施使用的成本摩擦表面的方法，开源路由机（OSRM）和谷歌地图，并将其与旅行时间由两个独立的驱动程序复制妇女的旅程。我们估计的百分比的妇女谁达到的设施在60和120分钟。385名妇女的平均旅行时间从成本摩擦表面的方法，OSRM和谷歌地图分别为5，11和40分钟。实际驾驶时间中位数为50-52分钟。成本摩擦表面方法和OSRM的平均误差>45分钟，Google Maps的平均误差为14分钟。周末夜间旅行的重复旅行时间和估计旅行时间之间的差异最小;最大的误差被发现在工作日的夜间旅程和超过120分钟的旅程。模拟估计表明，所有参与者在60分钟内的目的地CEMPC设施，但旅程复制显示，只有57%，现有的建模方法低估了低资源特大城市的实际旅行时间。必须紧急解决包括城市地区在内的地区在获得CEMEC等拯救生命的保健服务方面存在的巨大差距。如果要在2030年前实现全民健康覆盖目标，那么利用产生“更接近现实”的估计的工具对于服务规划至关重要。
Travel time to comprehensive emergency obstetric care (CEmOC) facilities in low-resource settings is commonly estimated using modelling approaches. Our objective was to derive and compare estimates of travel time to reach CEmOC in an African megacity using models and web-based platforms against actual replication of travel. We extracted data from patient files of all 732 pregnant women who presented in emergency in the four publicly owned tertiary CEmOC facilities in Lagos, Nigeria, between August 2018 and August 2019. For a systematically selected subsample of 385, we estimated travel time from their homes to the facility using the cost-friction surface approach, Open Source Routing Machine (OSRM) and Google Maps, and compared them to travel time by two independent drivers replicating women’s journeys. We estimated the percentage of women who reached the facilities within 60 and 120 min. The median travel time for 385 women from the cost-friction surface approach, OSRM and Google Maps was 5, 11 and 40 min, respectively. The median actual drive time was 50–52 min. The mean errors were >45 min for the cost-friction surface approach and OSRM, and 14 min for Google Maps. The smallest differences between replicated and estimated travel times were seen for night-time journeys at weekends; largest errors were found for night-time journeys at weekdays and journeys above 120 min. Modelled estimates indicated that all participants were within 60 min of the destination CEmOC facility, yet journey replication showed that only 57% were, and 92% were within 120 min. Existing modelling methods underestimate actual travel time in low-resource megacities. Significant gaps in geographical access to life-saving health services like CEmOC must be urgently addressed, including in urban areas. Leveraging tools that generate ‘closer-to-reality’ estimates will be vital for service planning if universal health coverage targets are to be realised by 2030.
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影响因子：
4.9
作者：
Makacha, Liberty;Makanga, Prestige Tatenda;von Dadelszen, Peter
通讯作者：
von Dadelszen, Peter
影响因子：
6.1
作者：
Olajide, Oluwafemi Ayodeji;Agunbiade, Muyiwa Elijah;Bishi, Hakeem Babatunde
通讯作者：
Bishi, Hakeem Babatunde
DOI：
10.1002/joc.1012
发表时间：
2004-03-30
期刊：
INTERNATIONAL JOURNAL OF CLIMATOLOGY
影响因子：
--
作者：
Odekunle, TO
通讯作者：
Odekunle, TO
影响因子：
2.7
作者：
Chen, Solomon Chih-Cheng;Wang, Jung-Der;Kolola-Dzimadzi, Rose
通讯作者：
Kolola-Dzimadzi, Rose
影响因子：
3.7
作者：
Ahmed, Shakil;Adams, Alayne M.;Panciera, Rocco
通讯作者：
Panciera, Rocco