Geographic accessibility to primary healthcare centers in MozambiqueReport as inadecuate




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International Journal for Equity in Health

, 15:173

Interventions in primary health care to improve outcome and equity in health

Abstract

BackgroundAccess 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.

MethodsHealth 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.

ResultsThe 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.

ConclusionsThis 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.

Trial registrationNot applicable.

KeywordsAccessibility Health centers Service area Mozambique Geographic information systems AbbreviationsGISGeographic information system

GPWGridded population of the world

GRUMPGlobal rural–urban mapping project

HCHealthcare centers

SAService area

WHOWorld Health Organization

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Author: António dos Anjos Luis - Pedro Cabral

Source: https://link.springer.com/







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