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Modelling and understanding primary health care accessibility and utilization in rural South Africa: An exploration using a geographical information system

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  • Tanser, Frank
  • Gijsbertsen, Brice
  • Herbst, Kobus

Abstract

Physical access to health care affects a large array of health outcomes, yet meaningfully estimating physical access remains elusive in many developing country contexts where conventional geographical techniques are often not appropriate. We interviewed (and geographically positioned) 23,000 homesteads regarding clinic usage in the Hlabisa health sub-district, KwaZulu-Natal, South Africa. We used a cost analysis within a geographical information system to estimate mean travel time (at any given location) to clinic and to derive the clinic catchments. The model takes into account the proportion of people likely to be using public transport (as a function of estimated walking time to clinic), the quality and distribution of the road network and natural barriers, and was calibrated using reported travel times. We used the model to investigate differences in rural, urban and peri-urban usage of clinics by homesteads in the study area and to quantify the effect of physical access to clinic on usage. We were able to predict the reported clinic used with an accuracy of 91%. The median travel time to nearest clinic is 81Â min and 65% of homesteads travel 1Â h or more to attend the nearest clinic. There was a significant logistic decline in usage with increasing travel time (p

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  • Tanser, Frank & Gijsbertsen, Brice & Herbst, Kobus, 2006. "Modelling and understanding primary health care accessibility and utilization in rural South Africa: An exploration using a geographical information system," Social Science & Medicine, Elsevier, vol. 63(3), pages 691-705, August.
  • Handle: RePEc:eee:socmed:v:63:y:2006:i:3:p:691-705
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    1. Baume, Carol & Helitzer, Deborah & Kachur, S. Patrick, 2000. "Patterns of care for childhood malaria in Zambia," Social Science & Medicine, Elsevier, vol. 51(10), pages 1491-1503, November.
    2. Perry, Baker & Gesler, Wil, 2000. "Physical access to primary health care in Andean Bolivia," Social Science & Medicine, Elsevier, vol. 50(9), pages 1177-1188, May.
    3. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    4. Egunjobi, Layi, 1983. "Factors influencing choice of hospitals: A case study of the Northern part of Oyo State, Nigeria," Social Science & Medicine, Elsevier, vol. 17(9), pages 585-589, January.
    5. Stock, Robert, 1983. "Distance and the utilization of health facilities in rural Nigeria," Social Science & Medicine, Elsevier, vol. 17(9), pages 563-570, January.
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