Mapping Health Disparities: Spatial Accessibility to Healthcare Facilities in a Rural District of Ghana Using Geographic Information Systems Techniques

Abstract

<i>Background:</i> Access to healthcare is crucial for health equity and outcomes, especially in resource-limited rural areas. Despite expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies. <i>Objective:</i> This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. <i>Methods:</i> Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. <i>Results:</i> Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p <.001) and secondary (χ²(1, N=80) = 15.93, p <.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p <.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p <.001) were significantly associated with healthcare access. <i>Conclusion:</i> This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.