Lila C Fleming1, Rashid Ansumana2,3, Alfred S Bockarie2, Joel D Alejandre4, Karen K Owen5, Umaru Bangura2, David H Jimmy2, Kevin M Curtin5, David A Stenger6, Kathryn H Jacobsen7. 1. Department of Environmental Science and Public Policy, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA. lflemin1@gmu.edu. 2. Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone. 3. Njala University, Bo, Sierra Leone. 4. Information Technology Division, U.S. Naval Research Laboratory, 4555 Overlook Avenue, SW Washington, DC, 20375, USA. 5. Department of Geography and Geoinformation Science, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA. 6. Center for Bio/Molecular Science and Engineering, U.S. Naval Research Laboratory, 4555 Overlook Avenue, SW Washington, DC, 20375, USA. 7. Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA.
Abstract
OBJECTIVES: To examine the diversity of the health-care providers in urban Bo, Sierra Leone, identify the types of health-care facilities preferred by women for fevers, and analyze the road network distances from homes to preferred health-care providers. METHODS: A population-based random sampling method was used to recruit 2419 women from Bo. A geographic information system was used to measure the road distance from each woman's home to her preferred provider. RESULTS: Preferred health-care providers for acute febrile illnesses (commonly referred to as "malaria" in the study communities) were hospitals (62.3 %), clinics (12.6 %), and pharmacies (12.4 %). Participants lived a median distance of 0.6 km from the nearest provider, but on average each woman lived 2.2 km one-way from her preferred provider. Women living farther from the city center had preferred providers significantly farther from home than women living downtown. CONCLUSIONS: The diverse health-care marketplace in Bo allows women to select clinical facilities from across the city. Most women prefer a malaria care provider farther from home than they could comfortably walk when ill.
OBJECTIVES: To examine the diversity of the health-care providers in urban Bo, Sierra Leone, identify the types of health-care facilities preferred by women for fevers, and analyze the road network distances from homes to preferred health-care providers. METHODS: A population-based random sampling method was used to recruit 2419 women from Bo. A geographic information system was used to measure the road distance from each woman's home to her preferred provider. RESULTS: Preferred health-care providers for acute febrile illnesses (commonly referred to as "malaria" in the study communities) were hospitals (62.3 %), clinics (12.6 %), and pharmacies (12.4 %). Participants lived a median distance of 0.6 km from the nearest provider, but on average each woman lived 2.2 km one-way from her preferred provider. Women living farther from the city center had preferred providers significantly farther from home than women living downtown. CONCLUSIONS: The diverse health-care marketplace in Bo allows women to select clinical facilities from across the city. Most women prefer a malaria care provider farther from home than they could comfortably walk when ill.
Entities:
Keywords:
Choice behavior; Health services accessibility; Sierra Leone; Urban population; West Africa
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