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Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

Tansley G, Schuurman N, Amram O, Yanchar N - PLoS ONE (2015)

Bottom Line: A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care.These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries.Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.

ABSTRACT
Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.

No MeSH data available.


Related in: MedlinePlus

Population-level spatial access to tertiary care in Namibia.Results from network analysis demonstrating the proportion of each census enumeration area’s population with spatial access to tertiary care within 50 kilometers of their residence.
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pone.0141113.g001: Population-level spatial access to tertiary care in Namibia.Results from network analysis demonstrating the proportion of each census enumeration area’s population with spatial access to tertiary care within 50 kilometers of their residence.

Mentions: Of the 410 facilities found to be operational in Namibia at the time of the SPA, 12.4%, 7.3%, and 1.2% were found to be capable of providing level A, B, and C care, respectively. 88% of facilities were found to be unsuitable for providing emergency care and were designated as level X. From these subsets of facilities, it was found through our network analysis that 28% (UI 24.2–29.8%) of the population was within 50km of road travel distance to tertiary care (Table 2 and Fig 1). The results for the additional facility levels and service area sizes are described in Table 2.


Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

Tansley G, Schuurman N, Amram O, Yanchar N - PLoS ONE (2015)

Population-level spatial access to tertiary care in Namibia.Results from network analysis demonstrating the proportion of each census enumeration area’s population with spatial access to tertiary care within 50 kilometers of their residence.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4631370&req=5

pone.0141113.g001: Population-level spatial access to tertiary care in Namibia.Results from network analysis demonstrating the proportion of each census enumeration area’s population with spatial access to tertiary care within 50 kilometers of their residence.
Mentions: Of the 410 facilities found to be operational in Namibia at the time of the SPA, 12.4%, 7.3%, and 1.2% were found to be capable of providing level A, B, and C care, respectively. 88% of facilities were found to be unsuitable for providing emergency care and were designated as level X. From these subsets of facilities, it was found through our network analysis that 28% (UI 24.2–29.8%) of the population was within 50km of road travel distance to tertiary care (Table 2 and Fig 1). The results for the additional facility levels and service area sizes are described in Table 2.

Bottom Line: A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care.These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries.Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.

ABSTRACT
Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.

No MeSH data available.


Related in: MedlinePlus