Abstract
Background
Achieving universal health equity remains a global challenge. The World Health Organization (WHO) advocates for universal health coverage (UHC) to ensure accessible, quality healthcare for all, regardless of financial status. Geographic Information System (GIS) technology has been instrumental in assessing healthcare accessibility, revealing gaps and informing policy decisions. This study investigates the geospatial distribution of Western healthcare facilities in Kalutara district, Sri Lanka, evaluating their accessibility.
Methods
A descriptive cross-sectional study was conducted from May 2019 to October 2019. The study geospatially mapped all healthcare institutions practicing Western medicine within Kalutara district and a 5km buffer zone beyond its boundaries. Data were collected using Epicollect5, a mobile application, ensuring accuracy within 10-15 meters. Variables included geospatial information and service availability. Data analysis was performed using ArcGIS 10.3, assessing coverage within buffer zones of 2km to 4km radii around each healthcare institution.
Results
General practitioners (GPs) covered 87.8% and 98.1% of the population within areas of 2km and 4km radii. All government institutions covered 21.8% and 67.6% of 2km and 4km radial buffer areas, while the coverage of private hospitals amounted to 3% and 8.8% respectively (i.e. within 2 km and 4km). It improved up to 64.1% and 90.0% by the inclusion of general practices. Majority of government hospitals and all private hospitals had inward care and 24x7 care. Blood banks were available only in 83.3% of specialized government hospitals. Of general practices, 10.6% had 24x7 care and 37.5% of private hospitals had ICU facilities. The study highlighted the significant role of general practitioners (GPs) in providing accessible healthcare, especially after routine working hours.
Conclusions:
GP settings contributed mainly in ensuring geographical access to healthcare. Hence, GP services need to be considered in all attempts of improving healthcare service delivery.