Evaluation of the Geographical Accessibility to Medical Services, Taking into Account the Environmental and Infrastructural Factors

Abstract

In this study we present what environment and infrastructure factors should be considered when evaluating geographical accessibility to medical services in developing countries.Access to medical services is a versatile and complex concept and includes geographical, temporal, financial and other factors. Geographical factors are considered as the basis for access to medical services. Geographical access to medical services means deployment of medical institutions within certain radius or time required for travel to the medical institution and the number of services compared to the number of potential customers. The World Health Organization gives preference to the travel time needed to reach the service compared to the distance to evaluate geographical accessibility.As a rule, while researching the geographical access to medical services in the world, it is generally accepted that every person is in the same average travel conditions and has appropriate transportation means. A change in the travel time, such as weather conditions, road and transport availability and other variable factors, are not taken into consideration.However, under the global warming conditions, the frequency and intensity of extreme hydrometeorological events are significantly increased and are likely to be increased further in future. Rain, snowfall, extreme temperature, hurricanes, etc. create emergencies, affect travel time and, thus, hamper geographical access. Moreover, in high mountainous regions, there are frequent landslides, mudflows, rockfalls, avalanches, etc. Developed countries are more willing to respond to such challenges and are quick to react. However, it is a significant problem in developing countries and often the rural areas are torn apart and isolated for many hours and even whole winter.Thus, when evaluating geographical accessibility to medical service in developing countries it is crucial to take into account the risks of extreme geological and hydrometeorological phenomena on the roads, availability of road infrastructure, transport system. This approach will enable detailed modelling of real problems and their inclusion in the health care development plan. This can bring significant social-economic benefits.This work was supported by Shota Rustaveli National Science Foundation of Georgia (SRNSFG), Grant № FR-19-14993.