Distance Cost Research Articles

Solving the Absolute 1-Center Problem in the Quickest Path Case

An undirected graph $$G=(V,A)$$ by a set V of n nodes, a set A of m edges, and a set $$D\subseteq V$$ consists of h demand nodes are given. Peeters (Eur J Oper Res 104:299–309, 1998) presented the absolute 1-center problem, which finds a point x placed on nodes or edges of the graph G with the property that the cost distance from the most expensive demand node to x is as cheap as possible. In the absolute 1-center problem, the distance between two nodes is computed through a shortest path between them. This paper expands the idea of Peeters (1998) and presents a new version of the absolute 1-center problem, which is called the absolute quickest 1-center problem. A value $$\sigma $$ is given, and the problem finds a point $$x^*$$ placed on nodes or edges of the graph G with the property that the transmission time of the quickest path to send $$\sigma $$ units of data from the farthest demand node to $$x^*$$ is the minimum value. We presented an $$O(r|D|(m+n\mathrm{{log}}\ n))$$ time algorithm to solve the absolute quickest 1-center problem, where r is the number of distinct capacity values.

Tiga Dihaji Dam Access Route Plan Alternative using Geographic Information System (Cost Distance Method)

The Tiga Dihaji dam access route function is destined for heavy equipment during the dam construction period. It is located on Tiga Dihaji sub-district, Ogan Komering Ulu Selatan district, South Sumatera, Indonesia. The Tiga Dihaji access route supervisor stated that the planning justification was done using expert judgement based on contour map and local land cover. This method is considered less measurable. Therefore, the Geographic Information System method is offered in this paper to determine the most suitable Tiga Dihaji dam access route. The parameters considered are landslide vulnerability, land cover and construction factors. These parameters are overlaid based on weights determined by the Public Works Department then validated by expert judgement. The new route is proposed using the cost distance method. Based on the analysis, it can be concluded that the cost distance method is more measurable than the planned method, but this method produces a less suitable route in terms of civil engineering.

A Stepwise GIS Approach for the Delineation of River Valley Bottom within Drainage Basins Using a Cost Distance Accumulation Analysis

River valley bottoms have hydrological, geomorphological, and ecological importance and are buffers for protecting the river from upland nutrient loading coming from agriculture and other sources. They are relatively flat, low-lying areas of the terrain that are adjacent to the river and bound by increasing slopes at the transition to the uplands. These areas have under natural conditions, a groundwater table close to the soil surface. The objective of this paper is to present a stepwise GIS approach for the delineation of river valley bottom within drainage basins and use it to perform a national delineation. We developed a tool that applies a concept called cost distance accumulation with spatial data inputs consisting a river network and slope derived from a digital elevation model. We then used wetlands adjacent to rivers as a guide finding the river valley bottom boundary from the cost distance accumulation. We present results from our tool for the whole country of Denmark carrying out a validation within three selected areas. The results reveal that the tool visually performs well and delineates both confined and unconfined river valleys within the same drainage basin. We use the most common forms of wetlands (meadow and marsh) in Denmark’s river valleys known as Groundwater Dependent Ecosystems (GDE) to validate our river valley bottom delineated areas. Our delineation picks about half to two-thirds of these GDE. However, we expected this since farmers have reclaimed Denmark’s low-lying areas during the last 200 years before the first map of GDE was created. Our tool can be used as a management tool, since it can delineate an area that has been the focus of management actions to protect waterways from upland nutrient pollution.

Open Capacitated ARC routing problem by Hybridized Ant Colony Algorithm

The Open Capacitated Arc Routing Problem OCARP is a well-known NP-hard real-world combinatorial optimization problem. It consists of determining optimal routes for vehicles in a given service area at a minimal cost distance. The main real application for OCARP is the Meter Reader Routing Problem (MRRP). In MRRP problem, each worker in the electric (or gas) company must visit and read the electric (or gas) meters to a set of customers by starting his route from the first customer on his visit list and finishing with the last one. The worker leaves where he wants once all the associated customers have been visited. In this paper, a metaheuristic called an Hybridized Ant Colony Algorithm (HACA) is developed and hybridized with a local search algorithm that involves the 2-opt, Swap, Relocate and Cross-exchange moves to solve OCARP problem. Computational results conducted on five different sets of OCARP-instances showed that our proposed algorithm HACA has reached good and competitive results on benchmark instances for the problem.

Sulfur-Doped Flowerlike Porous Carbon Derived from Metal–Organic Frameworks as a High-Performance Potassium-Ion Battery Anode

Amorphous carbon shows great potential in K+ storage due to its low cost and adjustable interlayer distance. However, the sluggish diffusion kinetics for K+ in carbon lattice and unsatisfied capaci...

The Time-Dependent Vehicle Routing Problem with Time Windows and Road-Network Information

Most time-dependent vehicle routing problems are based on a similar modeling paradigm: travel time information is represented by travel time functions between pairs of points of interest (e.g., depot or customers). Only a few papers investigate how these functions can be computed using the available travel time information. Furthermore, most of them neglect the possibility that different paths could be selected in the road network depending on the compromises they offer between cost (distance) and travel time. In this paper, we propose a new setting where travel time functions are defined on road-network arcs. We consider the Time-Dependent Vehicle Routing Problem with Time Windows and solve it with a branch-and-price algorithm. As far as we know, this is the first exact approach for a time-dependent vehicle routing problem when travel time functions are initially defined on the segments of a road-network.

Impacts of Solar Subsidy: Evidence from Geographic Regression Discontinuity Design in Nepal

Technology can help to reduce inefficiencies and inequalities in developing countries. Although whether this happens in practice often depends on the social and geographic context. Deployment of solar home systems (SHS) across Nepal provides one such example. We examine a policy to promote SHS through a subsidy for adoption and its downstream benefits - children’s education, time allocated to agricultural and household work (both unpaid), and working for a wage. We overcome the challenges of the non-random assignment of subsidies by using geographic regression discontinuity design using (cost) distance as the assignment variable. This is based on the assumption that households cannot perfectly control the assignment variable because migrating to a different region, simply to acquire an additional solar subsidy of maximum NRs4000, is challenging and unlikely in the case of Nepal. Our results show that subsidy-eligible households are about 43% more likely to adopt SHS. We find a positive effect of the SHS adoption on the grade for age and educational z-score of children’s educations with the effect being higher on girls than boys. We also find that females are 14.2% more likely to participate and spend more time (about 19 extra days in a year) in agricultural practices by reducing their engagement in family work. However, there is no effect on the participation rates across the labour market. Results also show that males increase their contribution to household work.

The Static Performance Effect of Hybrid- Hierarchical Interconnection by Shifted Completely Connected Network

Massively parallel computer (MPC) systems execute many operations based on internal networks called interconnection networks. The performance of these networks is affected by their topologies.There are many topologies of interconnection networks for MPC systems, unfortunately, they faced many drawbacks. Expanding the size of the network degrades the performance of these topologies. That is why this current paper presents a hybrid-hierarchical interconnection network (HIN) topology by Shifted Completely Connected Network (SCCN) to circumvent the drawbacks of the existing topologies. An experimental evaluation involving the design and development of a hierarchical network was carried out. A two-dimensional higher level networks has been produced and its static network performance parameters evaluated through simulators. The finding of the simulations has shown some good performances compared to many previous designed networks. SCCN is better than all conventional networks in terms of diameter, cost and average distance.

Application of linier fuzzy multi-objective programming model in travelling salesman problem

Traveling salesman problem is a problem where a salesman must visit a number of cities, each of which is visited exactly once only, and has to start from and return to the origin city. The objective of this traveling salesman is to determine an optimal travel route by minimizing travel cost or travel distance. If a decision maker wants to determine an optimal route by minimizing travel cost and distance simultaneously, they need more than one destination function, and therefore traveling salesman problem can be formulated as a multi-objective problem. In a traveling salesman problem, salesman make decisions by choosing an optimal route based on an expected measurement. In fact, a number of real problems cannot be expressed as a constraint function and resources in a definite form, so it is necessary to use fuzzy logic which allows us for making decisions based on bias or incorrect data. This paper will discuss a solution to the traveling salesman problem by using a fuzzy multi-objective model, which aims to determine an optimal route of the salesman. Results obtained from data processing of five places to visit by using a Maple 18 software included minimum cost, distance, and time with satisfaction level α = 0.89.

基于生境质量和生态安全格局的阿勒泰地区生态保护关键区域识别

随着生态文明建设上升为国家战略，生态安全与保护修复格局的识别成为国土空间规划战略中关于生态空间保护的重要内容。为了促进区域生态系统的保护修复及有效管理，从空间尺度上对区域生态安全和修复区域的识别必不可少。利用InVEST模型的Habitat Quality模块分析了阿勒泰地区1995年、2005年和2018年的生境质量变化状况，从生态环境保护的角度出发构建区域生态安全格局，结果发现：（1）1995-2018年阿勒泰地区生境质量处于中等水平，总体呈下降趋势，说明当地生态系统有不断退化趋势；（2）以生态结构系统性和生态过程完整性为目标，通过MSPA分析结合景观连通性识别出15块生态源地，处于阿勒泰北部的山间林地和乌伦古湖区域；利用ArcGIS软件的Cost Distance工具识别出阿勒泰地区有效生态廊道38条，长约2466km，总面积约80.08km²，其中草地和林地是生态廊道穿越的重点区域；识别出最小阻力路径与生态廊道交叉处的生态节点52个，主要分布在草地和林地区域；（3）通过生境质量与最小累积阻力值识别出三类生态保护关键区域，分别为生态涵养区、生态维护区和生态保育区，结合各类生态保护关键区域的存在的生态问题提出不同的生态保护方向。研究结果为阿勒泰地区生态保护修复按照三类生态保护分区分别提出了不同的保护方向，可为阿勒泰地区国土空间生态保护修复关键区域识别和为保障区域生态系统整体保护及可持续发展政策制定提供参考。;As the construction of ecological civilization has become a national strategy, the ecological space identification has become an important part of the contents of ecological protection in territory development plan. To promote regionally ecological protection, restoration and effective management, it is necessary to analyze and identify regional ecological security and restoration patterns. In this study, Habitat Quality module of InVEST Model is used to analyze Altay Prefecture's habitat quality changes in 1995, 2005 and 2018.We constructed regionally ecological security pattern from the perspective of ecological environment protection. The following conclusions were drawn.(1) From 1995 to 2018, the habitat quality in Altay Prefecture was at a medium level and showed a decrease trend which indicated that the local ecosystem had a continuous tendency of degradation. (2) Aiming to maintain systematicness of ecological structure and the integrity of ecological process, based on the morphological spatial pattern analysis (MSPA) combined with landscape connectivity method, there were fifteen ecological sources, which located in the north intermountain forest land and around Ulungur Lake. Thirty-eight effective ecological corridors with a length of about 2466km and about 80.08km² were identified which crossed among the grassland and forest in Altay Prefecture using Cost Distance toolbox of ArcGIS software. Fifty-two ecological nodes were mainly distributed in grassland and forest, which were identified at the intersection of least resistance paths and ecological corridors. (3) According to the habitat quality and the minimum cumulative resistance value, three types of crucial areas for ecological protection were classified, namely ecological conservation area, ecological maintenance area, and ecological breeding area. The research puts forward different ecological protection directions and proposes major tasks according to ecological-environmental problems in different crucial areas for ecological protection. The research provides different directions for ecological protection and restoration. Three ecological protection zones, which can offer references for identification of crucial areas and the comprehensive ecosystem protection and formulate sustainable development policies in Altay Prefecture.

Butterflies of fragmented wet grassland in Western European lowland forests: Effects of vegetation, connectivity and plot size

Habitat fragmentation, as a result of habitat loss and degradation, is widely considered to be a major threat to biodiversity. Our study focused on the distribution, diversity and abundance of butterflies on 22 isolated plots, mainly consisting of wet grassland. The plots were surrounded by deciduous mixed forests and located in an agglomeration area close to Lake Zurich, Switzerland. In addition to vegetation parameters, we assessed structural connectivity, adapted to least cost distances, using digital surface and terrain models. The resulting mixed-effects models revealed on plot level that (1) Molinia meadows had a significantly positive effect on rarefied Simpson butterfly diversity, (2) structural connectivity had a highly significant negative impact on rarefied Simpson butterfly diversity, whereas (3) plot size showed a significant positive impact, and (4) higher butterfly abundance was strongly related to blossom density. Across plot level, Molinia meadows had a higher rarefied butterfly species richness and rarefied Simpson butterfly diversity than any of the other habitat types evaluated. Among the endangered target species, the preferences of the Alcon Blue Phengaris alcon alcon were consistent with (1) to (3), while those of the Marsh Fritillary's E. aurinia aurinia were not. (2) is discussed with regards to the predominant influence of habitat type, vegetation and plot size, relativizing the effect of structural connectivity on butterfly communities in presumably resilient metapopulations. Ongoing targeted maintenance measures in the study area provide a promising basis for the sustainable conservation of local butterfly communities in isolated wet grassland plots.

Integrating the online OurRelationship program into a stepped‐care model of couple therapy

Due to various barriers, most relationally distressed couples do not seek couple therapy. With the COVID‐19 pandemic, many of these barriers are further exacerbated, while the need for relationship services has increased. To increase the reach of couple therapy both during and after the pandemic, we propose a stepped‐care model that utilises technology as a precursor to couple therapy and acts as an integral component of it. In this paper, we first introduce the OurRelationship program – an evidence‐based online relationship program that improves both relationship and individual functioning in several large‐scale, nationwide trials. We then describe how therapists can incorporate this program into an abbreviated, eight‐session course of couple therapy. We expect this integration will be useful to couple therapists from a variety of theoretical orientations and will address numerous common barriers to treatment including cost, scheduling difficulties and geographic distance from the therapist.Practitioner points Couple therapists can leverage technology to increase their reach both during and after the COVID‐19 pandemic. The online OurRelationship program improves relationship and individual functioning in several nationwide clinical trials. The OurRelationship program can be integrated into an eight‐session course of couple therapy to serve couples who would otherwise be unable or unwilling to attend therapy.

Patient Experience of an Osteoporosis Telemedicine Clinic

Rural Veterans at risk of fracture due to osteoporosis remain underdiagnosed and undertreated, in part due to location-related barriers to accessing care. Despite lowered cost and travel barriers to osteoporosis care through implementation of a telehealth model directed at rural at-risk Veterans that took advantage of many strengths of the VA’s healthcare system, only 30% of eligible Veterans accepted care. To understand low acceptance, we conducted 39 semi-structured telephone interviews with Veterans eligible for the clinic, including 19 who accepted screening and treatment, 12 who completed screening but declined treatment, and 8 who declined screening and treatment. Veterans who opted to be screened and/or treated for osteoporosis did so because: it was recommended by the VA; they were interested in learning more about their health; thought they may be at risk of osteoporosis; or believed screening would not cause them harm. Conversely, Veterans refused screening or treatment because of past negative experiences with medications, both bone and non-bone; a wish to not put anything else into their bodies; or the belief that their bone loss is not severe enough to warrant treatment. Outside medical professionals and peers influenced Veterans’ decisions to not take or alter their treatment. Cost and travel distance remained a barrier for Veterans who did not live near a VA facility with the necessary screening and treatment infrastructure. Many barriers to osteoporosis care remain despite efforts to remove them. Delivery systems must account for both instrumental and social access to care to reduce fracture risk.

Distance decay of benthic macroinvertebrate communities in a mountain river network: Do dispersal routes and dispersal ability matter?

Environmental heterogeneity and dispersal limitation are important drivers of beta diversity; however, their relative influence on the two fundamental components of beta diversity (i.e., species replacement and richness difference) has not been fully examined in montane streams. Here, we examined the relative importance of local environmental gradients and three physical distance matrices (i.e., overland, watercourse and cost distances) on beta diversity and its two components for a macroinvertebrate metacommunity in a stream network. To provide additional insights into community assembly, we also analysed variation in two deconstructed sub-communities based on dispersal ability (i.e., weak and strong dispersers). Both environmental filters and physical distances (dispersal limitation) drove patterns of overall beta diversity, with the former generally prevailing over the latter. Species replacement components showed stronger correlations with environmental gradients than physical distances, while the opposite is true for the richness difference components. Overland distances were generally more important than cost and watercourse distances for community dissimilarity of stream macroinvertebrates, implying that lateral dispersal out of stream corridors through flight was the major dispersal route in the studied steam network. As expected, community dissimilarity of strong dispersers was primarily shaped by environmental filtering, while community dissimilarity of weak dispersers was associated with the joint effects of environmental filtering and dispersal limitation. Our findings demonstrate that partitioning overall dissimilarity into species replacement and richness difference provides more insights into the processes driving spatial variability in biological communities compared with the utilization of total beta diversity alone. Our results support the notion that maintaining environmental heterogeneity and natural connectivity of stream networks should be effective measures to conserve regional biodiversity.

Models of zoning of urban territory for rational delivery in the microconsolidation system

Urban logistics (or city logistics) is developing rapidly due to the strong growth of e-commerce. Accordingly, the last-mile urban logistics faces a significant number of orders that need to be fulfilled in a dense urban development, environmental constraints and permanent congestion. One of the possible systems of rational city delivery is the use of a network of consolidation centers at the micro level. Such a network provides for a two-tier system of urban delivery - 1) from the central warehouse or warehouses to the network of microconsolidation centers; 2) from microconsolidation centers to end consumers. This scheme is especially relevant in the presence of restrictions on the movement of trucks or heavy vehicles in certain areas of the city, as well as in significant congestion and the problem of parking trucks when unloading at the location of the client. Methods (research methodology). To create a rational delivery network through a microconsolidation system, the primary task is to determine the delivery zones (or geographical clusters) - their number, size, location. To solve this problem, optimization models are proposed based on several minimization criteria - delivery distance, time, cost and integrated distance-time criterion. Results. The result is the optimization models creation, based on those it is possible to divide urban consumers into several delivery zones. Delivery routes are planned within each zone of the respective centroid and minimize the cost of last-mile logistics. Delivery of goods to the centroids can be carried out by light or medium trucks, and within the zones should be dominated by delivery of environmentally friendly modes of transport (motorcycle or moped, bicycle, car, on foot delivery with the possibility of public transport usage). Conclusion. Thus, the article provides a mathematical apparatus for obtaining territorial zoning of existing customers of the city in order to minimize the cost (distance, time or their combination) for delivery within each zone. Perspectives. A perspective study may be an analysis of the costs of operating a network of urban consolidation centers and the delivery of goods from the central warehouse or warehouses to this network. Accordingly, the task of minimizing the total costs of the city freight delivery system should be solved, taking into account economic, environmental and social aspects.

Identify Ecological Corridors and Build Potential Ecological Networks in Response to Recent Land Cover Changes in Xinjiang, China

Using Linkage Mapper corridor simulation software, which is based on minimum cost distance, we identify ecological corridors and build potential ecological networks in response to recent land cover changes in Xinjiang, China. Based on the analysis of land use/cover changes, the change of landscape pattern index is also calculated. The results show that: (1) During the year 2000–2015, cultivated land and built-up areas of Xinjiang showed an increasing trend. Due to urbanization, Xinjiang’s landscape connectivity is getting worse, and the landscape is becoming more and more fragmented and isolated. (2) We have constructed 296 ecological corridors, with a total length of 2.71 × 104 km and an average corridor length of 90.98 km. A total of 145 ecological source patches and 500 ecological nodes were connected by 296 ecological corridors. (3) The ecological corridor of Xinjiang presents the characteristics of “dense-north and sparse-south” in space. The areas with dense distribution of ecological corridors mainly include Urumqi, Changji, Turpan, Tacheng, Kizilsu Kirgiz, Karamay, and Yining, and the Taklimakan desert fringe. The sparse distribution is mainly in the whole Taklimakan desert.

Mapping physical access to health care for older adults in sub-Saharan Africa and implications for the COVID-19 response: a cross-sectional analysis

BackgroundSevere acute respiratory syndrome coronavirus 2, the virus causing COVID-19, is rapidly spreading across sub-Saharan Africa. Hospital-based care for COVID-19 is often needed, particularly among older adults. However, a key barrier to accessing hospital care in sub-Saharan Africa is travel time to the nearest health-care facility. To inform the geographical targeting of additional health-care resources, we aimed to estimate travel time at a 1 km × 1 km resolution to the nearest hospital and to the nearest health-care facility of any type for adults aged 60 years and older in sub-Saharan Africa.MethodsWe assembled a dataset on the geolocation of health-care facilities, separately for hospitals and any type of health-care facility and including both private-sector and public-sector facilities, using data from the OpenStreetMap project and the Kenya Medical Research Institute–Wellcome Trust Programme. Population data at a 1 km × 1 km resolution were obtained from WorldPop. We estimated travel time to the nearest health-care facility for each 1 km × 1 km grid using a cost–distance algorithm.Findings9·6% (95% CI 5·2–16·9) of adults aged 60 years or older across sub-Saharan Africa had an estimated travel time to the nearest hospital of 6 h or longer, varying from 0·0% (0·0–3·7) in Burundi and The Gambia to 40·9% (31·8–50·7) in Sudan. For the nearest health-care facility of any type (whether primary, secondary, or tertiary care), 15·9% (95% CI 10·1–24·4) of adults aged 60 years or older across sub-Saharan Africa had an estimated travel time of 2 h or longer, ranging from 0·4% (0·0–4·4) in Burundi to 59·4% (50·1–69·0) in Sudan. Most countries in sub-Saharan Africa contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of 12 h or longer and to the nearest health-care facility of any type of 6 h or longer. The median travel time to the nearest hospital for the fifth of adults aged 60 years or older with the longest travel times was 348 min (IQR 240–576; equal to 5·8 h) for the entire population of sub-Saharan Africa, ranging from 41 min (34–54) in Burundi to 1655 min (1065–2440; equal to 27·6 h) in Gabon.InterpretationOur high-resolution maps of estimated travel times to both hospitals and health-care facilities of any type can be used by policy makers and non-governmental organisations to help target additional health-care resources, such as makeshift hospitals or transport programmes to existing health-care facilities, to older adults with the least physical access to care. In addition, this analysis shows the locations of population groups most likely to under-report COVID-19 symptoms because of low physical access to health-care facilities. Beyond the COVID-19 response, this study can inform the efforts of countries to improve physical access to care for conditions that are common among older adults in the region, such as chronic non-communicable diseases.FundingBill & Melinda Gates Foundation.

Geospatial evaluation of trade-offs between equity in physical access to healthcare and health systems efficiency

IntroductionDecisions regarding the geographical placement of healthcare services require consideration of trade-offs between equity and efficiency, but few empirical assessments are available. We applied a novel geospatial framework to study...

82 Geographic Information System-Assisted Pediatric Surge Planning: Preparing Connecticut’s Hospitals to Respond to a Significant Storm Event

Disaster planning is one of the core roles for hospital leadership and public health bodies. As a result of climate change, there is increased urgency to prepare health care facilities to manage the care of patients during large storms. We hypothesize that planners can use Geographic Information Systems Mapping (GIS) to identify priority areas for emergency planning, model hurricane patterns within Connecticut (CT) and assess the impact on hospital accessibility, catchment area and pediatric surge. We mapped in GIS the 28 Connecticut (CT) acute care hospitals, roads, and the inundation layer of a Category (Cat) 4 Hurricane striking CT. Using pediatric data from the 2017 5-Year American Community Survey, which subset the CT population into 833 individual census tracts, alongside the cost distance and allocation tools in the ArcGIS Pro software, we calculated the pre- and post-flood catchment areas and maximum pediatric surge potential for the hospitals during a Cat 4 hurricane. A breakeven analysis for each hospital’s estimated storm-related pediatric surge was determined using the respective facility’s annually-averaged inpatient bed utilization data, reported to the state. The Center for Disease Control and Prevention’s Social Vulnerability Index (SVI), along with estimates of total affected children, were used to identify high vulnerability priority areas for emergency planning. During a Cat 4 hurricane, the potential surge to individual hospitals ranged from 0 to 15,215 children. Relative to pre-flood, post-flood catchment numbers decrease for 5 hospitals whilst increasing for 7 hospitals, ranging from -1,535 to +2,135, respectively. Using SVI with GIS, 17 tracts with 521 children/tract on average were identified as high priority areas. Each of these tracts were characterized by >30% poverty, >85 % minority status and >30% without vehicle access. All 17 priority tracks were identified within New Haven and Bridgeport. Statewide, if 0.41% (0.33%,0.52%) of children living in areas impacted by a Cat 4 hurricane are admitted to hospitals, CT’s acute care pediatric capacity (statewide aggregate) will be overwhelmed. In the range of 0.1-2% surge of affected children, no more than 7 of the 28 CT hospitals can provide pediatric beds to the estimated pediatric patient surge. Our findings indicate the potential surge in pediatric patients exceeds the staffed bed capacity of CT’s acute care hospitals during a Cat 4 hurricane. The interplay between geospatial data with health and demographic data provides an important means to ensure health systems are prepared to respond to emergencies. The information from this study, and the general methodology, can aid emergency planners to better prepare for a pediatric focused emergency and allow them to generate and improve contingency plans to manage such a surge.

Reluctance of women of lower socio-economic status to use maternal healthcare services - Does only cost matter?

In this paper we examine whether it is just the financial cost of maternal healthcare that prevents poor women from utilising free or low-cost government provided healthcare in Dhaka, Bangladesh, or there are other factors at play, in conjunction with poverty. To answer this question, we analyse the perceptions and experiences about the use of maternal health care for childbirth by a group of women residing in poor and lower socio-economic households in Dhaka. Data for this study were collected through in-depth interviews of 34 such women who have already had a child or had become pregnant at least once in the preceding five years. The findings of our analysis suggest that these women have a deeply rooted fear of medical intervention in childbirth for several perceived and practical reasons, including the fear of having to make undocumented payments, unfamiliarity with institutional processes, lack of social and family network support within their neighbourhood, concept of honour and shame [sharam], a culture of silence and inadequate spousal communication on health issues. As a result, even though low-cost health care facilities may be within their reach in terms of physical distance and affordable in terms of financial cost these women and their families are unwilling to deliver their babies at such health facilities. Therefore, in order to allay their perceived fear of hospital-based childbirth, one needs to consider factors other than financial cost and physical distance, and provide these women with factual information and culturally sensitive counselling.