Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana.
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
13
08
2018
revised:
24
06
2019
accepted:
25
06
2019
entrez:
14
9
2019
pubmed:
14
9
2019
medline:
14
9
2019
Statut:
epublish
Résumé
Access to referral healthcare facilities from primary healthcare (PHC) clinics for diagnostic services is critical for improving maternal health outcomes. We described the geographical distribution and accessibility to district hospitals/medical laboratories for comprehensive antenatal point-of-care (POC) diagnostic services in the Upper East region (UER), Ghana. We assembled detailed spatial data on 100 participated PHC clinics in our previous survey, their nearest referral district hospitals/medical laboratories, and landscape features influencing journeys in the UER. These were used in a geospatial model to estimate actual distance and travel time from a PHC facility to the nearest referral health facility for antenatal POC diagnostic services. Spatial distribution of the facilities was determined using spatial auto-correlation tool run in ArcMap 10.4.1. We employed Stata V14 for all other analysis. Of the 100 PHC clinics included in the analysis, only 15% were located less than 10 km to their nearest referral health facilities. The mean distance ± standard deviation from a PHC clinic to the nearest referral district hospital/medical laboratory for comprehensive antenatal POC diagnostic services was 7.0 km ± 4.9. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest referral health facility for comprehensive antenatal POC diagnostic was 14.0 min ± 8.8. The spatial auto-correlation results for the PHC clinics suggested that the PHC clinics were spatially distributed at random rather than clustered (MI = 0.01, z-score = 0.33, p = 0.74). Whereas the spatial distribution of the referral health facilities suggested that the hospitals or medical laboratories were spatially dispersed (MI = - 0.69 z-score = - 2.05, p = 0.04). Although there is moderate geographical accessibility to district hospitals/medical laboratories for comprehensive antenatal diagnostic services in the UER, targeted improvement of POC diagnostic services in PHC clinics is recommended for improved maternal healthcare. University of KwaZulu-Natal, College of Health Sciences Research Scholarship.
Sections du résumé
BACKGROUND
BACKGROUND
Access to referral healthcare facilities from primary healthcare (PHC) clinics for diagnostic services is critical for improving maternal health outcomes. We described the geographical distribution and accessibility to district hospitals/medical laboratories for comprehensive antenatal point-of-care (POC) diagnostic services in the Upper East region (UER), Ghana.
METHODS
METHODS
We assembled detailed spatial data on 100 participated PHC clinics in our previous survey, their nearest referral district hospitals/medical laboratories, and landscape features influencing journeys in the UER. These were used in a geospatial model to estimate actual distance and travel time from a PHC facility to the nearest referral health facility for antenatal POC diagnostic services. Spatial distribution of the facilities was determined using spatial auto-correlation tool run in ArcMap 10.4.1. We employed Stata V14 for all other analysis.
FINDINGS
RESULTS
Of the 100 PHC clinics included in the analysis, only 15% were located less than 10 km to their nearest referral health facilities. The mean distance ± standard deviation from a PHC clinic to the nearest referral district hospital/medical laboratory for comprehensive antenatal POC diagnostic services was 7.0 km ± 4.9. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest referral health facility for comprehensive antenatal POC diagnostic was 14.0 min ± 8.8. The spatial auto-correlation results for the PHC clinics suggested that the PHC clinics were spatially distributed at random rather than clustered (MI = 0.01, z-score = 0.33, p = 0.74). Whereas the spatial distribution of the referral health facilities suggested that the hospitals or medical laboratories were spatially dispersed (MI = - 0.69 z-score = - 2.05, p = 0.04).
INTERPRETATION
CONCLUSIONS
Although there is moderate geographical accessibility to district hospitals/medical laboratories for comprehensive antenatal diagnostic services in the UER, targeted improvement of POC diagnostic services in PHC clinics is recommended for improved maternal healthcare.
FUNDING
BACKGROUND
University of KwaZulu-Natal, College of Health Sciences Research Scholarship.
Identifiants
pubmed: 31517264
doi: 10.1016/j.eclinm.2019.06.015
pii: S2589-5370(19)30112-9
pmc: PMC6734000
doi:
Types de publication
Journal Article
Langues
eng
Pagination
74-80Déclaration de conflit d'intérêts
None declared.
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