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Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana

BACKGROUND: Access to referral healthcare facilities from primary healthcare (PHC) clinics for diagnostic services is critical for improving maternal health outcomes. We described the geographical distribution and accessibility to district hospitals/medical laboratories for comprehensive antenatal p...

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Autores principales: Kuupiel, Desmond, Adu, Kwame Manu, Bawontuo, Vitalis, Mashamba-Thompson, Tivani P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734000/
https://www.ncbi.nlm.nih.gov/pubmed/31517264
http://dx.doi.org/10.1016/j.eclinm.2019.06.015
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author Kuupiel, Desmond
Adu, Kwame Manu
Bawontuo, Vitalis
Mashamba-Thompson, Tivani P.
author_facet Kuupiel, Desmond
Adu, Kwame Manu
Bawontuo, Vitalis
Mashamba-Thompson, Tivani P.
author_sort Kuupiel, Desmond
collection PubMed
description BACKGROUND: Access to referral healthcare facilities from primary healthcare (PHC) clinics for diagnostic services is critical for improving maternal health outcomes. We described the geographical distribution and accessibility to district hospitals/medical laboratories for comprehensive antenatal point-of-care (POC) diagnostic services in the Upper East region (UER), Ghana. METHODS: We assembled detailed spatial data on 100 participated PHC clinics in our previous survey, their nearest referral district hospitals/medical laboratories, and landscape features influencing journeys in the UER. These were used in a geospatial model to estimate actual distance and travel time from a PHC facility to the nearest referral health facility for antenatal POC diagnostic services. Spatial distribution of the facilities was determined using spatial auto-correlation tool run in ArcMap 10.4.1. We employed Stata V14 for all other analysis. FINDINGS: Of the 100 PHC clinics included in the analysis, only 15% were located less than 10 km to their nearest referral health facilities. The mean distance ± standard deviation from a PHC clinic to the nearest referral district hospital/medical laboratory for comprehensive antenatal POC diagnostic services was 7.0 km ± 4.9. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest referral health facility for comprehensive antenatal POC diagnostic was 14.0 min ± 8.8. The spatial auto-correlation results for the PHC clinics suggested that the PHC clinics were spatially distributed at random rather than clustered (MI = 0.01, z-score = 0.33, p = 0.74). Whereas the spatial distribution of the referral health facilities suggested that the hospitals or medical laboratories were spatially dispersed (MI = − 0.69 z-score = − 2.05, p = 0.04). INTERPRETATION: Although there is moderate geographical accessibility to district hospitals/medical laboratories for comprehensive antenatal diagnostic services in the UER, targeted improvement of POC diagnostic services in PHC clinics is recommended for improved maternal healthcare. FUNDING: University of KwaZulu-Natal, College of Health Sciences Research Scholarship.
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spelling pubmed-67340002019-09-12 Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana Kuupiel, Desmond Adu, Kwame Manu Bawontuo, Vitalis Mashamba-Thompson, Tivani P. EClinicalMedicine Research Paper BACKGROUND: Access to referral healthcare facilities from primary healthcare (PHC) clinics for diagnostic services is critical for improving maternal health outcomes. We described the geographical distribution and accessibility to district hospitals/medical laboratories for comprehensive antenatal point-of-care (POC) diagnostic services in the Upper East region (UER), Ghana. METHODS: We assembled detailed spatial data on 100 participated PHC clinics in our previous survey, their nearest referral district hospitals/medical laboratories, and landscape features influencing journeys in the UER. These were used in a geospatial model to estimate actual distance and travel time from a PHC facility to the nearest referral health facility for antenatal POC diagnostic services. Spatial distribution of the facilities was determined using spatial auto-correlation tool run in ArcMap 10.4.1. We employed Stata V14 for all other analysis. FINDINGS: Of the 100 PHC clinics included in the analysis, only 15% were located less than 10 km to their nearest referral health facilities. The mean distance ± standard deviation from a PHC clinic to the nearest referral district hospital/medical laboratory for comprehensive antenatal POC diagnostic services was 7.0 km ± 4.9. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest referral health facility for comprehensive antenatal POC diagnostic was 14.0 min ± 8.8. The spatial auto-correlation results for the PHC clinics suggested that the PHC clinics were spatially distributed at random rather than clustered (MI = 0.01, z-score = 0.33, p = 0.74). Whereas the spatial distribution of the referral health facilities suggested that the hospitals or medical laboratories were spatially dispersed (MI = − 0.69 z-score = − 2.05, p = 0.04). INTERPRETATION: Although there is moderate geographical accessibility to district hospitals/medical laboratories for comprehensive antenatal diagnostic services in the UER, targeted improvement of POC diagnostic services in PHC clinics is recommended for improved maternal healthcare. FUNDING: University of KwaZulu-Natal, College of Health Sciences Research Scholarship. Elsevier 2019-07-03 /pmc/articles/PMC6734000/ /pubmed/31517264 http://dx.doi.org/10.1016/j.eclinm.2019.06.015 Text en © 2019 Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Kuupiel, Desmond
Adu, Kwame Manu
Bawontuo, Vitalis
Mashamba-Thompson, Tivani P.
Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title_full Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title_fullStr Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title_full_unstemmed Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title_short Geographical Accessibility to District Hospitals/Medical Laboratories for Comprehensive Antenatal Point-of-Care Diagnostic Services in the Upper East Region, Ghana
title_sort geographical accessibility to district hospitals/medical laboratories for comprehensive antenatal point-of-care diagnostic services in the upper east region, ghana
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734000/
https://www.ncbi.nlm.nih.gov/pubmed/31517264
http://dx.doi.org/10.1016/j.eclinm.2019.06.015
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