Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis

Abstract

Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution. 3. L'analyse reposait sur un rayon standard de 750 mètres de distance à partir des centres de soins, à une vitesse de marche d'un mètre par seconde et un temps d'accès souhaité aux centres de soins de santé de 12,5 minutes. La proportion de la population ayant un accès géographique inadéquat aux centres de soins a augmenté, passant de 47,3 % en 1997 à 58,4 % en 2012. La cartographie de la distance moyenne et standard jusqu'aux centres a révélé que la répartition spatiale des centres de soins de santé à Kermanshah devait être ajustée aux changements dans la répartition de la population. ‫اجلغرافية‬ ‫املعلومات‬ ‫لنظم‬

Investigating Inequalities in Access to Healthcare: The Case of Townships of Kermanshah, Iran

“…Therefore, the present study aimed to investigate inequality in access to medical care in the townships based in Kermanshah, Iran. The results of studying the status quo of the distribution of health resources in Kermanshah showed that there was heterogeneity in this regard, which was consistent with the results of studies stating that there were large gaps between different regions in Iran in terms of this factor [11,32,39,[43][44][45].In a study performed by , it was concluded that the factors such as lack of planning, wrong policymaking in terms of the distribution of health services, unfair distribution of financial resources and structural problems accounted for this situation [45].In addition, the consequences of the eight-year war between Iran and Iraq, economic sanctions, political-economic weaknesses, excessive population growth, and excessive migration of villagers to cities might account for this situation in Iran [46].Besides, the health status of people in various health issues, including diseases and other cases in Kermanshah will be negated by the lack of proper access to healthcare supplies [35,47]. In terms of the ratio of specialists to a population of 10,000 people, the results of the present study were indicative of an unequal distribution of facilities across the townships of Kermanshah Province.…”

“…The third step of this method was to calculate the human development which its value is between zero and one (the closer the obtained value to one, the more developed it will be [42].This was assessed by A) Mean Center: It is the mean of geographical latitude and longitude coordinates of all features within the scope of the study, and its calculation is appropriate for both tracking the changes in the spatial distribution of terrains and their comparisons. It is calculated as follows [11]:…”

“…Based on researches access to health services is a multi factorial issue and dependent on many differ determinate factors including: presence of facilities, personnel population density, socio-economic status, payments required, transport, willingness of health services to accept cultural minorities, physical accessibility for people with disabilities, gender considerations, and cultural attitudes and beliefs about health services and their usefulness. Besides, higher access and use of health services is more needed for some at risk groups such as: mothers, babies, older people or others in the population whose health is relatively more at risk-for example those with chronic health conditions [9][10][11][12][13][14]. In a situation where the provision of services is traditionally measured by indexes such as the number of physicians and hospital beds per unit of population [15], the fair distribution of health services has always been one of the major concerns of health systems worldwide [8,16].…”

“…The results of their research revealed that among 30 provinces of Iran, 12 were developed, nine were semi-developed, and nine were underdeveloped, in their categorization, Kermanshah Province was among the semi-developed provinces [33]. Studies conducted in Kermanshah the high significant rates for HIV/AIDS [34], cancer [35], cardiovascular diseases [36], accidents [37], high total fertility rates [38], and inadequate access to health centers [11].such evidences revealed the need for assessing healthcare resources and surviving the access to these cares. Since increasing the level of health and easy access to medical care are among the most prominent needs in development plans and considering the fact that the Kermanshah Province is one of the deprived provinces of Iran and given the prevalence of the above mentioned challenges in Kermanshah, this paper aimed to investigate the inequality in access to medical care in the townships based in Kermanshah, Iran according to population density.…”

Mathematical Modeling of High-risk Behaviors in Reformation and Social Assistance Centers

“…On the other hand, the studies have shown that Kermanshah has many health problems. Such as HIV/AIDS [2,3,13,16], cancer [17], high fertility [18,19], mortality [20,21], low quality of life [22,23] and lack of proper access to health centers [24][25][26][27]. As a result, it causes many health problems in the city.…”