Abstract
Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.
Highlights
Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need
For a health project focusing on accessibility to health facilities in Malawi, we explore both perceived difficulties in accessing health care and measured access to health services
Casas et al [3] compared potential versus revealed access to care in Colombia and found that the closest healthcare centre was rarely the patient’s choice, and that travel time is heavily influenced by income
Summary
Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. We hypothesize that there is a general relationship between perceived difficulties in accessing health services and measured accessibility: When measured accessibility is good, the perceived accessibility is good as well, and when measured accessibility is poor, the perceived accessibility is poor as well. This assumption has previously been confirmed by research that demonstrates a strong negative relationship between choice of health facility and the distance from where the patient is resident to the facility (e.g., [2]). Casas et al [3] compared potential versus revealed access to care in Colombia and found that the closest healthcare centre was rarely the patient’s choice, and that travel time is heavily influenced by income
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