Distribution of Primary Health Care Facilities in Kano Metropolis Using  GIS (Geographic Information System)

Kibon, Usman Ado; Ahmed, Mehreen

doi:10.19026/rjees.5.5710

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…The GIS indicated that the majority of the hospitals are located in districts with relatively higher socioeconomic status. Other studies also reported inequitable distribution of hospitals in urban settings [2, 38, 45] and a significant difference between public and private health facilities distributions [46]. This might imply an overlooked issue of inequality in healthcare and the financial and non-financial consequences it might have especially in highly populated cities [10, 47].…”

Section: Discussionmentioning

confidence: 98%

“…First, we used the administrative boundaries of the districts as reference points for identifying the locations of the hospitals and residential areas. Then, the hospitals were mapped against the floor area per capita of the residents using the Geographic Information System (GIS) in QGIS 3.8 software to have an insight about the geographical locations of the hospitals with respect to the SES of the residents [37, 38]. The QGIS is an open source software for mapping spatial data.…”

Section: Methodsmentioning

confidence: 99%

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Inequality in geographical distribution of hospitals and hospital beds in densely populated metropolitan cities of Iran

Chavehpour

Rashidian

Woldemichael

et al. 2019

BMC Health Serv Res

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Background This study aims to assess geographical distribution of hospitals and extent of inequalities in hospital beds against socioeconomic status (SES) of residents of five metropolitan cities in Iran. Methods A cross-sectional analysis was conducted to measure geographical inequality in hospital and hospital bed distributions of 68 districts in five metropolitan cities during 2016 using geographic information system (GIS), and Gini and Concentration indices. Correlation analysis was performed to show the relationship between the SES and inequality in hospital beds densities. Results The study uncovered marked inequalities in hospitals and hospital beds distributions. The Gini indices for hospital beds were greater than 0.55. The aggregated concentration indices for public and private hospital beds were 0.33 and 0.49, respectively. The GIS revealed that 216 (70.6%) hospitals were located in two highest socioeconomic status classes in the cities. Only 29 (9.5%) hospitals were located in the lowest class. The public, private, and the cumulative hospitals beds distributions in Tehran and Esfahan showed significant ( p < 0.05) positive correlation with SES of the residents. Conclusions The high inequalities in hospital and hospital beds distributions in our study imply an overlooked but growing concern for geographical access to healthcare in rapidly urbanizing metropolitan cities in Iran. Thus, regardless of ownership, decision-makers should emphasize the disadvantaged areas in metropolitan cities when need arises for the establishment of new healthcare facilities in order to ensure fairness in healthcare. The metropolitan cities and rapid urbanization settings in other countries could learn lessons to reduce or prevent similar issues which might have hampered access to healthcare.

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Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Inequality in geographical distribution of hospitals and hospital beds in densely populated metropolitan cities of Iran

Chavehpour

Rashidian

Woldemichael

et al. 2019

BMC Health Serv Res

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“…The study was conducted in Nassarawa LGA, which is one of the metropolitan LGAs in Kano [27]. This LGA has an area of 35km 2 with a high prevalence of slum settlements [28].…”

Section: Methodsmentioning

confidence: 99%

A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme

et al. 2019

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Background We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0–23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria. Methods This cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0–23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively. Results Caregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV. Conclusion The study identified important local factors that are responsible for MOV which can be addressed in the QI programme.

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“…This LGA is one of the metropolitan LGAs in Kano State. 16 It is located in Kano Central senatorial district. It has an area of about 35 km 2 with a population of 596,669 according to the 2006 National Population and Housing Census.…”

Section: Study Settingmentioning

confidence: 99%

Using the consolidated framework for implementation research (CFIR) to assess the implementation context of a quality improvement program to reduce missed opportunities for vaccination in Kano, Nigeria: a mixed methods study

Adamu

Uthman

Gadanya

et al. 2019

Human Vaccines & Immunotherapeutics

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Background: Although understanding implementation context is essential, there is a dearth of research on how to systematically explore it in quality improvement (QI) programs. Therefore, in this study, we used the consolidated framework for implementation research (CFIR) to guide a systematic evaluation of the implementation context of an ongoing QI program in order to generate rapid site-specific feedback that can be used to improve subsequent plan-do-study-act (PDSA) cycles. Methods: Formative cross-case evaluation was conducted using convergent mixed methods design. The study was conducted in five primary health care (PHC) facilities (PHC 1, PHC 3, PHC 5, PHC 9 and PHC 10) implementing the QI program. Health workers in those facilities formed the study population. Quantitative data were collected using a self-administered, Likert-based rating tool, while qualitative data collection was guided by an interview guide. The interviews were transcribed verbatim, and thematic analysis was performed. Raw median score and factor scores were computed. Methodological integration occurred at the design, analysis and reporting stage. Results: A total of 165 health workers were included in this study with a mean age of 33.43 years (standard deviation of 7.15). Majority were females and they all had post-secondary education. Health workers in two facilities; PHC 1 and PHC 5, reported higher score for the QI program across all five domains of CFIR. Implementation facilitators included intervention flexibility, relative advantage, selfefficacy among health workers, health workers confidence in the intervention, services integration. While implementation barriers included vaccine stock out, faulty cold chain infrastructure, lack of incentives, and socio-cultural beliefs. Conclusion:This study demonstrated that theory-driven formative evaluation can be integrated in QI programs in a low resource setting. It buttressed the value in conducting such assessment as they can be used to generate rapid feedback on factors that influence implementation success which can then be addressed in subsequent cycles.

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Distribution of Primary Health Care Facilities in Kano Metropolis Using GIS (Geographic Information System)

Cited by 9 publications

References 3 publications

Inequality in geographical distribution of hospitals and hospital beds in densely populated metropolitan cities of Iran

Inequality in geographical distribution of hospitals and hospital beds in densely populated metropolitan cities of Iran

A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme

Using the consolidated framework for implementation research (CFIR) to assess the implementation context of a quality improvement program to reduce missed opportunities for vaccination in Kano, Nigeria: a mixed methods study

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