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Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis

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  • Gavin Tansley
  • Nadine Schuurman
  • Ofer Amram
  • Natalie Yanchar

Abstract

Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country’s population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.

Suggested Citation

  • Gavin Tansley & Nadine Schuurman & Ofer Amram & Natalie Yanchar, 2015. "Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-12, November.
  • Handle: RePEc:plo:pone00:0141113
    DOI: 10.1371/journal.pone.0141113
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    1. Catherine Linard & Marius Gilbert & Robert W Snow & Abdisalan M Noor & Andrew J Tatem, 2012. "Population Distribution, Settlement Patterns and Accessibility across Africa in 2010," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-8, February.
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    1. Hiranya Sritart & Kuson Tuntiwong & Hiroyuki Miyazaki & Somchat Taertulakarn, 2021. "Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand," IJERPH, MDPI, vol. 18(20), pages 1-24, October.
    2. Samuel Manda & Ndamonaonghenda Haushona & Robert Bergquist, 2020. "A Scoping Review of Spatial Analysis Approaches Using Health Survey Data in Sub-Saharan Africa," IJERPH, MDPI, vol. 17(9), pages 1-20, April.

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