Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all t...Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all the people proposed by central government of China. Using the spatial analysis and the statistical analysis, this study evaluates the spatial differentiation of medical care facilities accessibility by constructing STT(Shortest Travel-Time) and SAI(Spatial Accessibility Index). And then this study explores the neighborhood effects on the medical care facilities accessibility in Beijing, with a particular focus on the effect of neighborhood migrant proportion by constructing spatial dependent regression model. The spatial accessibility analysis of medical care facilities show that the spatial distribution of medical care facilities was basically consistent with administrative regions but not with population demands. Bivariate LISA cluster maps identify that suburban areas are the overlapped clusters of high percent of migrants and limited medical care services. This is associated with the public service allocation rule in China, which stresses equality within urban areas and within rural areas but overlooks equality between urban areas and rural areas; and stresses local resident demands but overlooks migrant demands. To estimate the effects on medical care accessibility of neighborhood migrant proportion, spatial dependence models are applied due to spatial dependence of accessibility of medical care facilities. The regression results show that neighborhoods with high percent of migrants, even conditioning on neighborhood SES, are related to limited spatial accessibility of medical care services. Besides neighborhood characteristics, another important factor influencing spatial accessibility of medical care services is the process of spatial spillover effects. This indicates that the attenuate accessibility of medical care services for migrants is not only because of their own constraints but also because of their proximity to other disadvantaged neighborhoods. Therefore, it is urgently needed to increase the medical facilities in the suburban areas, to take into account migrants' demands and to reduce residential segregation between local residents and migrants for local governments to achieve the goal of equalization of medical care service.展开更多
Ensuring healthy lives and promoting well-being for all ages is the 3rd Sustainable Development Goal(SDG).Inequality in access to health care remains one of the primary challenges in achieving the goal.With the ever-i...Ensuring healthy lives and promoting well-being for all ages is the 3rd Sustainable Development Goal(SDG).Inequality in access to health care remains one of the primary challenges in achieving the goal.With the ever-increasing expansion of urban areas and population growth,there is a need to regularly examine the pattern of accessibility of basic amenities across regions,States and urban areas.This study examined geographic access to Primary Health Care Facilities(PHCF)in Nigeria using the combination of open data and geospatial analysis techniques.Thus,showcasing an approach can be replicated across different regions in Sub-Saharan Africa due to issues of information gap.Data on elevation,location of health care facilities,population and network data were utilised.The result shows that PHCF aggregate at certain locations,e.g.major urban agglomerations,and transit route leading to these places.High concentrations are found in the capital city.The average travel time to the nearest PHCF is about 14 min(Standard Deviation±13.30 min)while the maximum is about 2 hours.Pockets of low accessibility areas exist across the Akwa Ibom State in the Niger Delta region of Nigeria.There is an indication that most places have good geographic access.Across the 1787 settlements identified in our dataset,98.3%are with good access(<30 min),27 settlements are located in the poor access class(31–60 min),while two settlements are within the very poor access class(>60 min).Geographic access is not the main limiting factor to health care access in the region.Therefore,computation of access to health care should take into consideration other dimensions of accessibility,to create a robust measure which will support effective and efficient health care planning and delivery.展开更多
Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 marri...Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.展开更多
基金Under the auspices of National Natural Science Foundation of China(No.41701151)MOE(Ministry of Education in China)Project of Humanities and Social Sciences(No.17YJCZH256)Doctoral Project of Tianjin Normal University(No.52XB1621)
文摘Spatial equality of access to basic public services, especially medical care services which are directly related to life safety, is the first step to achieve the goal of equalization of basic public services for all the people proposed by central government of China. Using the spatial analysis and the statistical analysis, this study evaluates the spatial differentiation of medical care facilities accessibility by constructing STT(Shortest Travel-Time) and SAI(Spatial Accessibility Index). And then this study explores the neighborhood effects on the medical care facilities accessibility in Beijing, with a particular focus on the effect of neighborhood migrant proportion by constructing spatial dependent regression model. The spatial accessibility analysis of medical care facilities show that the spatial distribution of medical care facilities was basically consistent with administrative regions but not with population demands. Bivariate LISA cluster maps identify that suburban areas are the overlapped clusters of high percent of migrants and limited medical care services. This is associated with the public service allocation rule in China, which stresses equality within urban areas and within rural areas but overlooks equality between urban areas and rural areas; and stresses local resident demands but overlooks migrant demands. To estimate the effects on medical care accessibility of neighborhood migrant proportion, spatial dependence models are applied due to spatial dependence of accessibility of medical care facilities. The regression results show that neighborhoods with high percent of migrants, even conditioning on neighborhood SES, are related to limited spatial accessibility of medical care services. Besides neighborhood characteristics, another important factor influencing spatial accessibility of medical care services is the process of spatial spillover effects. This indicates that the attenuate accessibility of medical care services for migrants is not only because of their own constraints but also because of their proximity to other disadvantaged neighborhoods. Therefore, it is urgently needed to increase the medical facilities in the suburban areas, to take into account migrants' demands and to reduce residential segregation between local residents and migrants for local governments to achieve the goal of equalization of medical care service.
文摘Ensuring healthy lives and promoting well-being for all ages is the 3rd Sustainable Development Goal(SDG).Inequality in access to health care remains one of the primary challenges in achieving the goal.With the ever-increasing expansion of urban areas and population growth,there is a need to regularly examine the pattern of accessibility of basic amenities across regions,States and urban areas.This study examined geographic access to Primary Health Care Facilities(PHCF)in Nigeria using the combination of open data and geospatial analysis techniques.Thus,showcasing an approach can be replicated across different regions in Sub-Saharan Africa due to issues of information gap.Data on elevation,location of health care facilities,population and network data were utilised.The result shows that PHCF aggregate at certain locations,e.g.major urban agglomerations,and transit route leading to these places.High concentrations are found in the capital city.The average travel time to the nearest PHCF is about 14 min(Standard Deviation±13.30 min)while the maximum is about 2 hours.Pockets of low accessibility areas exist across the Akwa Ibom State in the Niger Delta region of Nigeria.There is an indication that most places have good geographic access.Across the 1787 settlements identified in our dataset,98.3%are with good access(<30 min),27 settlements are located in the poor access class(31–60 min),while two settlements are within the very poor access class(>60 min).Geographic access is not the main limiting factor to health care access in the region.Therefore,computation of access to health care should take into consideration other dimensions of accessibility,to create a robust measure which will support effective and efficient health care planning and delivery.
文摘Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.
