Investigating Access to Reproductive Health Services Using GIS: Proximity to Services and the Use of Modern Contraceptives in Malawi

Heard, Nathan; Larsen, Ulla; Hozumi, Dairiku

doi:10.2307/3583189

Cited by 38 publications

(23 citation statements)

References 13 publications

(1 reference statement)

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“…Therefore, we utilized geolocation facility data, and employed kernel density estimation (KDE) using the Spatial Analyst tools feature in ArcGIS version 10.3.1 [21] to estimate access to FP/RH services. The density of RHC service availability has been found to be a good proxy for access to FP/RH services than other measures of accessibility such as Euclidean distance [22]. …”

Section: Methodsmentioning

confidence: 99%

“…KDE is characterized by the degree to which geographically close points (RHC facilities) that are at the center of the radius tend to be weighted higher than facilities at the margin [22, 23]. We created density variables by converting all of the geolocation facility data for each RHC facility, conflict and protest data (latitude and longitude) into continuous surfaces.…”

Section: Methodsmentioning

confidence: 99%

“…KDE requires the user to specify the choice of circle radius. In this study, we use a radius of 4 km to represent an hour of travel time by foot as used in a previous study [22]. …”

Section: Methodsmentioning

confidence: 99%

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Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

2017

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BackgroundVery little is known about reproductive health service (RHS) availability and adolescents’ use of these services in post-conflict settings. Such information is crucial for targeted community interventions that aim to improve quality delivery of RHS and outcomes in post-conflict settings. The objectives of this study therefore was to examine the density of RHS availability; assess spatial patterns of RHC facilities; and identify youth-friendly practices associated with adolescents’ use of services in post-conflict Burundi.MethodsA cross-sectional survey was conducted from a full census of all facilities (n = 892) and provider interviews in Burundi. Surveyed facilities included all public, private, religious and community association owned-centers and hospitals. At each facility efforts were made to interview the officer-in-charge and a group of his/her staff. We applied both geospatial and non-spatial analyses, to examine the density of RHS availability and density, and to explore the association between youth-friendly practices and adolescents’ use of RHS in post-conflict Burundi.ResultsHigh spatial patterning of distances of RHC facilities was observed, with facilities clustered predominantly in districts exhibiting persistent violence. But, use of services remained undeterred. We further found a stronger association between use of RHS and facility and programming characteristics. Community outreach, designated check-in/exam rooms, educational materials (posters, print, and pictures) in waiting rooms, privacy and confidentiality were significantly associated with adolescents’ use of RHS across all facility types. Cost was associated with use only at religious facilities and youth involvement at private facilities. No significant association was found between provider characteristics and use of RHS at any facility.ConclusionsOur findings indicate the need to improve youth-friendly service practices in the provision of RHS to adolescents in Burundi and suggest that current approaches to provider training may not be adequate for improving these vital practices. Our mixed methods approach and results are generalizable to other countries and post-conflict settings. In post-conflict settings, the methods can be used to identify service availability and spatial patterns of RHC facilities to plan for targeted service interventions, to increase demand and uptake of services by youth and young adults.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

2017

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“…Although GIS is increasingly used to assess the accessibility of health services on the provincial 10,37,38 or national 12,13,39,40 level in sub-Saharan Africa, this is among the first analyses in this region to use GIS to investigate travel time for TB evaluation at a local level. This study also used a gridded travel-time surface that permitted travel off of the road network, in contrast to many accessibility studies done in developed countries that calculate travel over the road network.…”

Section: Discussionmentioning

confidence: 99%

Investigating Barriers to Tuberculosis Evaluation in Uganda Using Geographic Information Systems

Ross¹,

Cattamanchi²,

Miller³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Reducing geographic barriers to tuberculosis (TB) care is a priority in high-burden countries where patients frequently initiate, but do not complete, the multi-day TB evaluation process. Using routine cross-sectional study from six primary-health clinics in rural Uganda from 2009 to 2012, we explored whether geographic barriers affect completion of TB evaluation among adults with unexplained chronic cough. We measured distance from home parish to health center and calculated individual travel time using a geographic information systems technique incorporating roads, land cover, and slope, and measured its association with completion of TB evaluation. In 264,511 patient encounters, 4,640 adults (1.8%) had sputum smear microscopy ordered; 2,783 (60%) completed TB evaluation. Median travel time was 68 minutes for patients with TB examination ordered compared with 60 minutes without (P < 0.010). Travel time differed between those who did and did not complete TB evaluation at only one of six clinics, whereas distance to care did not differ at any of them. Neither distance nor travel time predicted completion of TB evaluation in rural Uganda, although limited detail in road and village maps restricted full implementation of these mapping techniques. Better data are needed on geographic barriers to access clinics offering TB services to improve TB diagnosis.

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“…Furthermore, because this study was conducted in an urban environment where individuals use different modes of transportation, including walking, bus, subway, and driving, unique travel time for each client is difficult to calculate. Other studies have used centroids to measure travel distance when addresses are unavailable [34,35]. The variable, RC, was used to investigate the influence of between-client racial concordance.…”

Section: Model Specificationmentioning

confidence: 99%

Communities of color? Client-to-client racial concordance in the selection of mental health programs for Caucasians and African Americans

Koizumi

Rothbard

Smith

et al. 2011

Health Care Manag Sci

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A discrete-choice logit model was applied to study the determinants of mental health provider choice using data from a large urban county in the Northeast US. The study subjects were 9,544 adult Medicaid recipients who received outpatient treatment from the 20 Community Mental Health Center (CMHC) programs in 2001. In addition to a conventional set of variables representing client and provider characteristics, the regression model included several interaction terms to examine whether racial concordance level among patients influences the choice of an outpatient program. The results revealed that racial concordance among the clients seems to be a factor in choosing a program. In particular, Caucasian clients are much more likely to select a program with a higher percentage of Caucasian clients, even though they have to travel further. More generally, our results suggest that program choice may be driven more by the racial composition of the clients served than by spatial proximity to the program.

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Investigating Access to Reproductive Health Services Using GIS: Proximity to Services and the Use of Modern Contraceptives in Malawi

Cited by 38 publications

References 13 publications

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

Investigating Barriers to Tuberculosis Evaluation in Uganda Using Geographic Information Systems

Communities of color? Client-to-client racial concordance in the selection of mental health programs for Caucasians and African Americans

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