Mahbub E Chowdhury1, Taposh K Biswas1, Monjur Rahman1, Kamal Pasha2, Mollah A Hossain2,3. 1. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. 2. Center for Environmental and Geographic Information Services, Dhaka, Bangladesh. 3. Institute of Water Modelling, Dhaka, Bangladesh.
Abstract
OBJECTIVE: To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). METHODS: A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. RESULTS: The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. CONCLUSION: Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems.
OBJECTIVE: To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). METHODS: A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. RESULTS: The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. CONCLUSION: Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems.
Keywords:
Bangladesh; Basic emergency obstetric and neonatal care; Comprehensive emergency obstetric and neonatal care; Emergency obstetric and newborn care; Geographic information system; Public facilities
Authors: Steeve Ebener; Karin Stenberg; Michel Brun; Jean-Pierre Monet; Nicolas Ray; Howard Lawrence Sobel; Nathalie Roos; Patrick Gault; Claudia Morrissey Conlon; Patsy Bailey; Allisyn C Moran; Leopold Ouedraogo; Jacqueline F Kitong; Eunyoung Ko; Djenaba Sanon; Farouk M Jega; Olajumoke Azogu; Boureima Ouedraogo; Chidude Osakwe; Harriet Chimwemwe Chanza; Mona Steffen; Imed Ben Hamadi; Hayat Tib; Ahmed Haj Asaad; Tessa Tan Torres Journal: BMJ Glob Health Date: 2019-07-01