von Dadelszen, P; Makanga, PT; Magee, LA; Schuurman, N; Sacoor, C; Boene, H; Vilanculo, F; Vidler, M; Sevene, E; Munguambe, K
(2017)
Seasonal variation in geographical access to maternal health services in regions of southern Mozambique.
International Journal of Health Geographics, 16.
p. 1.
ISSN 1476-072X
https://doi.org/10.1186/s12942-016-0074-4
SGUL Authors: von Dadelszen, Peter
Abstract
Background
Geographic proximity to health facilities is a known determinant of access to maternal care. Methods of quantifying geographical access to care have largely ignored the impact of precipitation and flooding. Further, travel has largely been imagined as unimodal where one transport mode is used for entire journeys to seek care. This study proposes a new approach for modeling potential spatio-temporal access by evaluating the impact of precipitation and floods on access to maternal health services using multiple transport modes, in southern Mozambique.
Methods
A facility assessment was used to classify 56 health centres. GPS coordinates of the health facilities were acquired from the Ministry of Health while roads were digitized and classified from high-resolution satellite images. Data on the geographic distribution of populations of women of reproductive age, pregnancies and births within the preceding 12 months, and transport options available to pregnant women were collected from a household census. Daily precipitation and flood data were used to model the impact of severe weather on access for a 17-month timeline. Travel times to the nearest health facilities were calculated using the closest facility tool in ArcGIS software.
Results
Forty-six and 87 percent of pregnant women lived within a 1-h of the nearest primary care centre using walking or public transport modes respectively. The populations within these catchments dropped by 9 and 5% respectively at the peak of the wet season. For journeys that would have commenced with walking to primary facilities, 64% of women lived within 2 h of life-saving care, while for those that began journeys with public transport, the same 2-hour catchment would have contained 95% of the women population. The population of women within two hours of life-saving care dropped by 9% for secondary facilities and 18% for tertiary facilities during the wet season.
Conclusions
Seasonal variation in access to maternal care should not be imagined through a dichotomous and static lens of wet and dry seasons, as access continually fluctuates in both. This new approach for modelling spatio-temporal access allows for the GIS output to be utilized not only for health services planning, but also to aid near real time community-level delivery of maternal health services.
Item Type: |
Article
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Additional Information: |
© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
Keywords: |
Public Health, 1604 Human Geography |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
International Journal of Health Geographics |
ISSN: |
1476-072X |
Dates: |
Date | Event |
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13 January 2017 | Published Online | 8 December 2016 | Accepted |
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Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
Project ID | Funder | Funder ID |
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0197 | Grand Challenges Canada - Stars in Global Health Program | UNSPECIFIED | OPP1017337 | Bill and Melinda Gates Foundation | UNSPECIFIED |
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URI: |
https://openaccess.sgul.ac.uk/id/eprint/108520 |
Publisher's version: |
https://doi.org/10.1186/s12942-016-0074-4 |
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