Journal of Remote Sensing & GIS

Spatial Distribution and Geographic Accessibility to Primary Healthcare Facilities in Oyo State, Nigeria

Akinwale Emmanuel Oluwayinka^* Department of Geography, University of Lagos, Akoka, Lagos, Nigeria
^*Correspondence: Akinwale Emmanuel Oluwayinka, Department of Geography, University of Lagos, Akoka, Lagos, Nigeria, Email:

Received: 16-Nov-2023, Manuscript No. JGRS-23-23931; Editor assigned: 20-Nov-2023, Pre QC No. JGRS-23-23931 (PQ); Reviewed: 04-Dec-2023, QC No. JGRS-23-23931; Revised: 11-Dec-2023, Manuscript No. JGRS-23-23931 (R); Published: 18-Dec-2023, DOI: 10.35248/2469-4134.23.12.322

Introduction

Adequate access to healthcare facility is one of the distinguished characteristics of a developed society because good health is a very important [1,2]. The Nigerian health sector consists of the public and private primary health care’s whereby the public primary healthcare are further divided into primary, secondary and tertiary health care facilities [2,3]. Access to health care has several definitions and its meaning in a given context is too often assumed [4]. The most basic problem is that it is both a noun referring to potential for health care use and a verb referring to the act of using or receiving health care and this led to confusion between the ability to get care, the act of seeking care, the actual delivery of care and indicators thereof. Adequate access to healthcare facilities is one of the characteristics that set a developed society apart, as good health is so important [1]. Primary, secondary, and tertiary healthcare facilities in the public sector comprise the Nigerian health sector, which is composed of both public and private facilities [2,3]. The pattern of health-care facility accessibility across regions, states, and metropolitan areas must be regularly evaluated due to the population growth and rapid expansion of urban areas. These are especially important in areas with high population densities because disease outbreaks might result from poor access to medical services [3].

The absence of health insurance, ambulatory services, and a poor transportation infrastructure in Nigeria add to the need for health care facilities to be close to the population, particularly in rural areas where automobile ownership is minimal. According to studies, the distributional pattern of healthcare facilities impacts the population’s access to healthcare, such that some segments of the population are either at an advantage or at a disadvantage depending on where they live. In addition, the degree of justice in the spatial distribution of healthcare facilities affects the level of access to those facilities. According to Inyang, the problem in the healthcare industry is not entirely due to service quality, but rather to the adequacy of primary health care facilities available.

Geographic accessibility has been widely used as a scientific method for accessing the distribution and accessibility to health care services and it can be used to measure the disparities in the opportunities to access health care among various groups or regions [5]. Geographic accessibility has been examined with respect to socio-organization and geographical terms [6,7].

According to George et al. (2020), geographic accessibility to healthcare is concerned with the relationship between the population’s spatial separation and the availability of healthcare facilities. Access is categorized along several broad categories, including: Spatial accessibility, which takes into account class, age, sex, health seeking behaviour, cultural traits, and people’s knowledge of health and health care, may also play a role in determining access to healthcare. Geographic accessibility which relates to factors like time or distance between health service providers and consumers.

Musa and Abdulhamed (2012) have investigated how accessibility issues affect the use of healthcare facilities in Nigeria’s Jigawa state [8,9]. According to the research, there is an uneven distribution of healthcare facilities, which is caused by a number of variables. Political factors as well as a desire to locate the facilities in urban areas.

In Kano Metropolis, Kano State, Nigeria, Kibon and Ahmed (2013) constructed a database that evaluates the types and patterns of basic healthcare facilities. According to the research, there is an uneven distribution of PHC Facilities, with the west of the country receiving the least amount of care. Some communities were underserved as a result of the majority of the facilities being grouped together. In order to avoid unfairness in the distribution of PHC facilities and staff, it was advised that the current situation be looked into.

According to Onamade, 2014, economic factors like household living standards, antenatal care costs, and, in particular, expenditures related to distance to healthcare facilities, appear to have a significant impact on the demand for antenatal treatment from contemporary health care providers.

Primary healthcare facilities should be located no more than 5 km from the people they serve, following the WHO guideline. Additionally, there must to be a primary healthcare facility in each ward. The accessibility and dispersion of primary healthcare facilities has been the subject of numerous studies. When a secondary or tertiary health facility is inaccessible, primary healthcare facilities play a critical role in providing emergency medical care. As a result, this condition will be managed until it is moved to a secondary or tertiary hospital. On the other hand, not much research has been done on Oyo State’s primary health care coverage and geographic accessibility. As a result, the study aims to investigate the degree of accessibility, as well as the distance to the primary healthcare facilities in the study area.

Materials and Methods

Study area

The study covered Oyo state. It is located between Latitude 7o 0’ 0’’ N and 9o0i 0ii and Longitude 3o 0’ 0’’ E and 4o 0’ 0’’ E. Oyo State is bordered to the north by Kwara State, to the east by Osun State, and to the southwest by Ogun State and the Republic of Benin. With a projected population of 8,218,180 in 2021, Oyo State is the fifth most populous in the country.

Oyo State is an inland state in south western Nigeria. Its capital is Ibadan, the third most populous city in the country and formerly the second most populous city in Africa. Oyo State covers approximately an area of 28,4542 km and it has 33 local governments (Figure 1).

Figure 1: Study area map. Note: Nigeria; Oyo state.

Data

Secondary data was used for this study. The primary healthcare facilities data was collected from Oyo State ministry of health. Also, the state boundary consisting of all the LGA was obtained from OSGOF (Office of the Surveyor General of the Federation). The 2006 national population data for each local government was collected from National Population Commission and was projected to 2022 using geometric method at the growth rate of 2.58% (Table 1).

Table 1: Population and primary health care facilities data

Evaluating the geographic distribution and accessibility of the primary health care facilities

Measuring geographic accessibility: Gesler (1986) published a complex and comprehensive taxonomy of spatial analysis for the broader field of medical geography. However, most published measures of Geographic accessibility to health care can be classified more simply into four categories:

• Provider to population ratios

• Distance to the nearest provider

• Average distance to a set of providers

• Gravitational models of provider influence (Mark, 2004).

Provider to population ratios and the distance to the closest provider were used in this study because they both concentrate more on the degree of geographic accessibility to the healthcare providers, which is what the study seeks to examine. The provider- to-population ratio is one of the most important aspects to consider when determining the location of a healthcare facility [5]. The total population that each LGA’s primary healthcare facilities can serve was calculated for this scenario.

Conversely, the distance to the closest healthcare provider indicates that access to primary healthcare shouldn’t be too far away from the populace. Healthcare facilities should be located no more than 5 km from the population, under the WHO’s (2020) benchmark. This implies that a single medical facility has to be able to provide care to everyone within a 5 km radius.

Analysing geographic accessibility

All primary healthcare facilities were exported into an ArcGIS environment in order to map out the distribution of primary healthcare throughout the state. The distributional pattern of primary healthcare institutions throughout the state was then displayed using Nearest Neighbour analysis.

In order to determine the population within the WHO’s recommended 5 km radius, a 5 km buffer was constructed from the main healthcare institution’s site. Using the union analysis tool in ArcGIS, the geographic accessibility catchment zone was superimposed on the state boundary map. Using the Zonal statistics as table’ tool in ArcGIS, the output of the union operation was intersected with the population density map. A population total for the access zone (5 km) was computed, and the resulting chloropleth map was made. ArcGIS was also used to determine the mean, maximum, and lowest distances between settlements and the nearest medical institution. The following formula is used to calculate the new population:

New population=New area/Old area × Present population

Using the aforementioned calculation, the new population that will have access to primary healthcare within a 5 km travel radius was determined. If they reside outside the 5 km radius, the remaining population will have to travel more than 5 km to access primary healthcare facilities.

Results and Discussion

NNA, or nearest neighbour analysis, was used to establish the distribution’s pattern. A clustered pattern is shown by the NNA’s derived index, which is close to 0.63. The clustered distribution of these facilities in Ibadan and the city’s denser population could be reasons for the uneven distribution of primary health care facilities throughout the study area. These results are in line with those of Lou and Wang who found that a variety of locational factors, such as population size, accessibility to facilities from nearby settlements, accessibility of approachable roads, rocky terrains, etc., may be responsible for the distribution of health care facilities in a given area. A map layer was generated showing the distribution of primary health care facilities in the study area (Table 2, Figures 2 and 3).

Table 2: Showing population within and outside 5km WHO recommended distance.

Figure 2: Map showing the distribution of population and primary health care facilities in the study area. Note: Primary health care; Oyo state boundary.

Figure 3: Map showing the distributional pattern of primary health care facilities in the study area. Note: Nearest Neighbour ratio: 0.624631; z-score: -16.025199; p-value: 0.000000.

From Table 2, out of the total population of 8,218,422 million in the study area, the total population within the 5 km recommended distance was estimated to be around 5,797,824 million, indicating that a population of about 5,797,824 million can access primary health care facilities within the 5 km recommended distance. Additionally, it was estimated that 2,420,598 million people will travel more than 5 km to access primary health care facilities.

ArcGIS was used to calculate the population’s access to primary healthcare as a percentage, based on Table 3, above. A 5 km catchment zone barrier was established. Subsequently, the state border map incorporating all local governments was combined with the catchment zone. The formula New area/old area* by the current population was used to compute the population inside the 5 km catchment zone. This formula was then used to get the population percentage for the entire LGA. The findings indicate that, within the WHO recommended 5 km radius, all residents of LGAs such as Akinyele, Ibadan North, Ibadan North East, Ibadan North West, Ibadan South East, Ibadan South West, Lagelu, and Oyo East have easy access to primary healthcare facilities. These show that there are enough primary healthcare facilities for the general public to have access to within a 5-kilometer radius of the LGAs. It is evident from other LGAs that have less than 100% of their population within the suggested 5 km radius that those LGAs require the construction of additional primary healthcare facilities. For example, there are the fewest primary health care facilities within the recommended 5 km radius in Atiba LGA (15.57%) (Table 3).

Table 3: Distance of population to primary health care facilities.

Table 3 shows the population’s mean, minimum and maximum distance from primary health care facilities. Additionally, we can observe that some rural areas have very short minimum travel distances to primary healthcare facilities less than 4 km which is possible because the population density in those areas affects the use of basic healthcare services. This is because the institutions can still provide some primary health care services to the public even in areas with low population densities. There may not be enough primary health care facilities in a region with a growing population to serve the majority of the population as a result of the area’s expanding population.

It was estimated that the average distance between all the settlements and the closest primary healthcare institution was 2.68 km. According to Table 3, the estimated minimum and maximum distances to the closest primary health care institution were 0.3 km and 12 km, respectively. Akinyele has the smallest mean distance to primary healthcare services, whereas Saki West has the meanest distance to primary healthcare facilities. The mean distance between all the communities in thirty LGA in the region and the closest primary healthcare services was more than 5 km. Oyo West and Ibarapa Central, respectively, are the LGAs with the shortest and longest travel times to the closest primary healthcare facilities.

Conclusion

The information showed that there are different patterns of uneven distribution of primary healthcare facilities throughout the study area. According to the statistics, cities have a higher concentration of primary healthcare facilities than rural areas. According to Olanrewaju et al. (2018), primary healthcare institutions tend to congregate in particular locations, primarily urban centres, as evidenced by the findings of this study. The size of a region’s population and the quantity of primary healthcare facilities there affect how much of that region is covered by these facilities. The government should spend more in the study area to provide adequate primary health care services. Despite their population, certain LGAs have a scarcity of primary health care services.

Within the WHO recommended 5 km radius, every population in each LGA should have easy access to any primary health care services in its area. To fully realize GIS’s potential, institutionalization of GIS in Oyo state and nation-wide is required.

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