Measures of spatial accessibility to health centers: investigating urban and rural disparities in Kermanshah, Iran

Abstract

Availability of and accessibility to health services are critical factors to maintain the wellbeing of any society. This study aims to investigate the spatial patterns and accessibility levels of urban and rural residents to health centers—i.e., hospitals—in the case of Kermanshah Province located at the western part of Iran. The study employs a spatial analysis technique as the methodological approach. Datasets were obtained from the latest population statistics—i.e., the 2011 Population and Housing Census—and public and private hospitals in the Kermanshah Province. Access levels to health centers were calculated in a geographical information system environment with network analysis capability. The results revealed that: (a) spatial distribution of health centers in the Kermanshah Province follows a random pattern, (b) health centers are mainly concentrated in the Kermanshah Township, (c) there is a clear inequality in terms of access to health centers in the Kermanshah Province, (d) children, women, and the elderly residing in rural areas are found to be the most vulnerable groups. The bipolar status of the rural population’s access to healthcare compared with those residing in the Kermanshah Township clearly underlines an unequal structure of the health system in the Kermanshah Province. There is, hence, a need for effective interventions of policymakers and health managers in the province to eliminate this disparity.