scholarly journals National and subnational estimates of coverage and travel time to emergency obstetric care in Afghanistan: Modeling of spatial accessibility

2020 ◽  
Vol 66 ◽  
pp. 102452 ◽  
Author(s):  
Christine Kim ◽  
Hannah Tappis ◽  
Philip McDaniel ◽  
Mohammad Samim Soroush ◽  
Bruce Fried ◽  
...  
Keyword(s):  
Travel Time ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Spatial Accessibility

scholarly journals The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Rocco Panciera ◽  
Akib Khan ◽  
Syed Jafar Raza Rizvi ◽  
Shakil Ahmed ◽  
Tanvir Ahmed ◽  
...  
Keyword(s):  
Travel Time ◽  
Urban Poor ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Seeking ◽  
Care Seeking Behavior ◽  
Seeking Behavior

scholarly journals Referral transit time between sending and first-line receiving health facilities: a geographical analysis in Tanzania

2019 ◽  
Vol 4 (Suppl 5) ◽  
pp. e001568
Author(s):  
Michelle M Schmitz ◽  
Florina Serbanescu ◽  
George E Arnott ◽  
Michelle Dynes ◽  
Paul Chaote ◽  
...  
Keyword(s):  
Travel Time ◽  
Time Delays ◽  
Friction Surface ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Health Facilities ◽  
Referral System ◽  
Surface Model ◽  
Levels Of Care ◽  
Total Travel Time

BackgroundTimely, high-quality obstetric services are vital to reduce maternal and perinatal mortality. We spatially modelled referral pathways between sending and receiving health facilities in Kigoma Region, Tanzania, identifying communication and transportation delays to timely care and inefficient links within the referral system.MethodsWe linked sending and receiving facilities to form facility pairs, based on information from a 2016 Health Facility Assessment. We used an AccessMod cost-friction surface model, incorporating road classifications and speed limits, to estimate direct travel time between facilities in each pair. We adjusted for transportation and communications delays to create a total travel time, simulating the effects of documented barriers in this referral system.ResultsMore than half of the facility pairs (57.8%) did not refer patients to facilities with higher levels of emergency obstetric care. The median direct travel time was 25.9 min (range: 4.4–356.6), while the median total time was 106.7 min (22.9–371.6) at the moderate adjustment level. Total travel times for 30.7% of facility pairs exceeded 2 hours. All facility pairs required some adjustments for transportation and communication delays, with 94.0% of facility pairs’ total times increasing.ConclusionHalf of all referral pairs in Kigoma Region have travel time delays nearly exceeding 1 hour, and facility pairs referring to facilities providing higher levels of care also have large travel time delays. Combining cost-friction surface modelling estimates with documented transportation and communications barriers provides a more realistic assessment of the effects of inter-facility delays on referral networks, and can inform decision-making and potential solutions in referral systems within resource-constrained settings.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals “In cities, it’s not far, but it takes long”: comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria

2021 ◽  
Vol 6 (1) ◽  
pp. e004318
Author(s):  
Aduragbemi Banke-Thomas ◽  
Kerry L M Wong ◽  
Francis Ifeanyi Ayomoh ◽  
Rokibat Olabisi Giwa-Ayedun ◽  
Lenka Benova
Keyword(s):  
Travel Time ◽  
Friction Surface ◽  
Obstetric Care ◽  
Travel Times ◽  
Night Time ◽  
Google Maps ◽  
Surface Approach ◽  
Low Resource ◽  
Life Saving ◽  
The Cost

BackgroundTravel time to comprehensive emergency obstetric care (CEmOC) facilities in low-resource settings is commonly estimated using modelling approaches. Our objective was to derive and compare estimates of travel time to reach CEmOC in an African megacity using models and web-based platforms against actual replication of travel.MethodsWe extracted data from patient files of all 732 pregnant women who presented in emergency in the four publicly owned tertiary CEmOC facilities in Lagos, Nigeria, between August 2018 and August 2019. For a systematically selected subsample of 385, we estimated travel time from their homes to the facility using the cost-friction surface approach, Open Source Routing Machine (OSRM) and Google Maps, and compared them to travel time by two independent drivers replicating women’s journeys. We estimated the percentage of women who reached the facilities within 60 and 120 min.ResultsThe median travel time for 385 women from the cost-friction surface approach, OSRM and Google Maps was 5, 11 and 40 min, respectively. The median actual drive time was 50–52 min. The mean errors were >45 min for the cost-friction surface approach and OSRM, and 14 min for Google Maps. The smallest differences between replicated and estimated travel times were seen for night-time journeys at weekends; largest errors were found for night-time journeys at weekdays and journeys above 120 min. Modelled estimates indicated that all participants were within 60 min of the destination CEmOC facility, yet journey replication showed that only 57% were, and 92% were within 120 min.ConclusionsExisting modelling methods underestimate actual travel time in low-resource megacities. Significant gaps in geographical access to life-saving health services like CEmOC must be urgently addressed, including in urban areas. Leveraging tools that generate ‘closer-to-reality’ estimates will be vital for service planning if universal health coverage targets are to be realised by 2030.

MEASURING SPATIAL HEALTHCARE FACILITIES ACCESSIBILITY USING TWO-STEP FLOATING CATCHMENT ANALYSIS (2SFCA) (Case Study: Cianjur Regency, Indonesia)

2021 ◽  
pp. 11
Author(s):  
Muhamad Iqbal Januadi Putra ◽  
Nabila Dety Novia Utami
Keyword(s):  
Travel Time ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
Healthcare Facilities ◽  
Spatial Disparities ◽  
Time Threshold

The presence of healthcare facilities is quite essential to provide good healthcare services in a particular area, however, the existence of healthcare facilities is not evenly distributed in Cianjur Regency. This condition leads to the disparities of healthcare facilities across the Cianjur Regency. In this paper, we aim to measure and map the spatial disparities of healthcare facilities using a Two-Step Floating Catchment Analysis (2SFCA). This method can calculate the magnitude of spatial accessibility for healthcare facilities by formulating the travel time threshold and the quality of healthcare facilities across the study area. This research shows the result that the spatial accessibility of healthcare facilities in the Cianjur Regency is not evenly distributed across the districts. The spatial accessibility value resulted from 2SFCA is ranging from 0- 3.97. A low value indicates low spatial accessibility, while a higher value shows good accessibility. The majority of districts in the Cianjur Regency have the spatial accessibility value 0-0.5 (86%). Meanwhile, only a few have the higher value; value 0.5-0.99 as much as 6.6%, 0.99-1.49 as 3.3%, and 3.48-3.97 has a percentage of 3.3%. Also, this analysis results in the cluster of good spatial accessibility in healthcare facilities, namely the Pagelaran District and Cipanas District. Interestingly, the downtown of Cianjur Regency has lower spatial accessibility compared to both areas.

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