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Measuring spatial accessibility to healthcare for people living with HIV-AIDS in southern Nigeria

Ojo, William LU (2018) In Master Thesis in Geographical Information Science GISM01 20172
Dept of Physical Geography and Ecosystem Science
Abstract
Equitable distribution of healthcare services towards the reduction of HIV-AIDS prevalence in Nigeria remains a major public health concern. One of several research model to solve this public health problem is the use Geographical Information System, a two-step floating catchment area (2SFCA), this model emerged in the last decade as a key measure of spatial accessibility, particularly in its application to healthcare access.
The 2SFCA approach was used to study the influence of distance to health center on people living with HIV-AIDS. Individual, health and administrative data from the South-South region of Nigeria were used in this study for two scenarios, at 30 and 60 minutes travel time. At a threshold travel time of 30 minutes, the... (More)
Equitable distribution of healthcare services towards the reduction of HIV-AIDS prevalence in Nigeria remains a major public health concern. One of several research model to solve this public health problem is the use Geographical Information System, a two-step floating catchment area (2SFCA), this model emerged in the last decade as a key measure of spatial accessibility, particularly in its application to healthcare access.
The 2SFCA approach was used to study the influence of distance to health center on people living with HIV-AIDS. Individual, health and administrative data from the South-South region of Nigeria were used in this study for two scenarios, at 30 and 60 minutes travel time. At a threshold travel time of 30 minutes, the 2SFCA results showed minimum accessibility index score of 0.45 HIV-AIDS services with access to services by 16% of HIV infected population. At 60 minutes threshold, there was a minimum of 0.24 HIV services accessible index score, only 12% had access to HIV-AIDS services. Spatial autocorrelations for Global Moran’s I showed a significant clustered pattern at 30 minutes threshold. Anselin Local Moran’s I revealed the extent of hotspots pattern identifying eleven LGAs to be of high-high cluster. Furthermore, analysis of variance test statistic also compared the effect of accessibility index score and the household knowledge on distance or travel time as a barrier to HIV services, the test statistic at (p<0.05) showed significant differences between the States.
These results are key decision-making factor for local authorities to establish equitable access to HIV-AIDS population in the South-South region. Conclusively, this showed a shortage of HIV services in all the States, distance and means of transport remains a significant hindrance to healthcare access, these can be addressed with the incorporation of Geographical Information System in future monitoring strategy. (Less)
Popular Abstract
Inequitable distribution of healthcare services causes slow rollback of HIV-AIDS prevalence in Nigeria, with the concentration of the most HIV infected people living in the southern part of the country.
The use of two-step floating catchment model derived from Geographical Information System measured the distribution of health centers with respect to the population in need of HIV-AIDS services. The catchment model demonstrated the effect of travel time scenarios; from a place of residence to health center, using household, health and administrative data.
The scenario results at 30 and 60 minutes travel time showed low accessibility for almost one-fifth of the population, and low accessibility for one-tenth of the population respectively.... (More)
Inequitable distribution of healthcare services causes slow rollback of HIV-AIDS prevalence in Nigeria, with the concentration of the most HIV infected people living in the southern part of the country.
The use of two-step floating catchment model derived from Geographical Information System measured the distribution of health centers with respect to the population in need of HIV-AIDS services. The catchment model demonstrated the effect of travel time scenarios; from a place of residence to health center, using household, health and administrative data.
The scenario results at 30 and 60 minutes travel time showed low accessibility for almost one-fifth of the population, and low accessibility for one-tenth of the population respectively. Furthermore, inferential statistics of spatial autocorrelation (Global and Local Moran’s I) showed a significant clustered pattern at 30 minutes scenario with some hotspots identified, while a random pattern was seen at 60 minutes scenario. This established that travel time is a barrier to HIV-AIDS services.
This evidence is a wake up call for local authorities in every district to expand the use of this model for equitable re-distribution of health centers, since, inability to rollback HIV-AIDS prevalence further drives the population into poverty. Once these gaps are filled, poverty and inequality will be reduced, and socio-economic status boosted (Less)
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author
Ojo, William LU
supervisor
organization
alternative title
Geographical measure of healthcare accessibility
course
GISM01 20172
year
type
H2 - Master's Degree (Two Years)
subject
keywords
geographical information system, healthcare, hiv-aids
publication/series
Master Thesis in Geographical Information Science
report number
81
language
English
id
8932484
date added to LUP
2018-01-16 17:29:51
date last changed
2018-01-16 17:29:51
@misc{8932484,
  abstract     = {{Equitable distribution of healthcare services towards the reduction of HIV-AIDS prevalence in Nigeria remains a major public health concern. One of several research model to solve this public health problem is the use Geographical Information System, a two-step floating catchment area (2SFCA), this model emerged in the last decade as a key measure of spatial accessibility, particularly in its application to healthcare access. 
The 2SFCA approach was used to study the influence of distance to health center on people living with HIV-AIDS. Individual, health and administrative data from the South-South region of Nigeria were used in this study for two scenarios, at 30 and 60 minutes travel time. At a threshold travel time of 30 minutes, the 2SFCA results showed minimum accessibility index score of 0.45 HIV-AIDS services with access to services by 16% of HIV infected population. At 60 minutes threshold, there was a minimum of 0.24 HIV services accessible index score, only 12% had access to HIV-AIDS services. Spatial autocorrelations for Global Moran’s I showed a significant clustered pattern at 30 minutes threshold. Anselin Local Moran’s I revealed the extent of hotspots pattern identifying eleven LGAs to be of high-high cluster. Furthermore, analysis of variance test statistic also compared the effect of accessibility index score and the household knowledge on distance or travel time as a barrier to HIV services, the test statistic at (p<0.05) showed significant differences between the States. 
These results are key decision-making factor for local authorities to establish equitable access to HIV-AIDS population in the South-South region. Conclusively, this showed a shortage of HIV services in all the States, distance and means of transport remains a significant hindrance to healthcare access, these can be addressed with the incorporation of Geographical Information System in future monitoring strategy.}},
  author       = {{Ojo, William}},
  language     = {{eng}},
  note         = {{Student Paper}},
  series       = {{Master Thesis in Geographical Information Science}},
  title        = {{Measuring spatial accessibility to healthcare for people living with HIV-AIDS in southern Nigeria}},
  year         = {{2018}},
}