Geog 624: DEVELOPMENTAL CHANGES IN HUMAN HEALTH

Lecture: Accessibility and Utilization of Health Services

By
Prof. Samuel Agyei-Mensah
 Accessibility and Utilization of
Health Services
 Accessibility is defined as a function of the
attributes of a location where physical proximity to
a service contributes to an individual’s welfare by
conferring choice, opportunity and use
enhancement”.
 The SDG three targets aims to;
Quality Healthcare for all
achieve universal health coverage,
 The Ghana Health Service (GHS) is mandated to
deliver primary and secondary healthcare through
public health institutions
 Are there private healthcare facilities in Ghana?
 Accessibility and Utilization of
Health Services
 Two types of Accessibility;
Potential Accessibility: defined as the possible chance
to participate in spatially dispersed opportunity, based
on calculated measures. and
Actual/Behavioral Accessibility: defined as the
subjective basis on which individuals choose an
opportunity without considering measures
 Impact of distance on access and utilization of
health services in Ghana.
Is distance only physical?
 Accessibility and Utilization of
Health Services
 The role of Distance
– Map distance
– Road Distance
– Time Distance
– Mobility
– Perceived Distance
– Economic Distance
– Social Distance
 Accessibility and Utilization of
Health Services
 Two major factors influence an individual’s
accessibility and utilization to healthcare service;
Spatial Factors
Aspatial factors
 Spatial Factors
Location
Distance
Transport/Road
Time
Class and Quality of service
Cost
Geographical differences (urban -rural)
 Accessibility and Utilization of
Health Services
 Non-Spatial Factors
– Socio-economic Status
– Access to insurance
– Transportation to and from health-care sites
– People with disabilities
– Legislative, executive, or state actions
– Social welfare schemes
– Socio-cultural/Social interactions
 Accessibility and Utilization of
Health Services
 There is spatial inequality in the provisioning
of healthcare services in GAMA.
 GAMA has a ratio of 3.42 health facilities to
10,000 individuals.
 The highest number of healthcare facilities,
144, is in the Accra Metropolitan Assembly.
 The Accra Metropolitan Assembly (AMA) has
a population of 555,767
Accessibility and Utilization of
Health Services
 Accessibility and Utilization of
Health Services
 When there is a lack of equitable access to
healthcare the poor, vulnerable, women and
children are most affected
 Fundamental impediments to healthcare service
utilization:
 Distance
 transport costs,
 vehicular congestion and
 long waiting queues.
 Accessibility and Utilization of
Health Services
 How does the spatial and a spatial
factors influence health service
utilization?
 Members of poor households would instead go to a
pharmacy to obtain medication or perform a test than
go to the clinic or hospital when a child has malaria
 High utilization of pharmacies as a source of primary
healthcare, especially among individuals of low
socioeconomic status.
 References
• Meade et. al (1988) Chapter 11, Accessibility and Utilization, pages 306-312. In
Medical Geography (eds). Meade, M, John Florin, & W. Gesler.
• Kissah-Korsah, K. (2008). Spatial accessibility to health care facilities in the
Ajumako-Enyan-Essiam and Upper Denkyira Districts in the Central Region of
Ghana. Norwegian Journal of Geography, 62: 203-209
• Agbenyo, F., Marshall Nunbogu, A., & Dongzagla, A. (2017). Accessibility mapping
of health facilities in rural Ghana. Journal of Transport & Health, 6, 73-83.
https://doi.org/https://doi.org/10.1016/j.jth.2017.04.010
• Agyapong, & Ojo, T. K. (2018). Managing traffic congestion in the Accra Central
Market, Ghana. Journal of Urban Management, 7(2), 85-96.
https://doi.org/10.1016/j.jum.2018.04.002
• Agyapong, A., Afi, J. D., & Kwateng, K. O. (2018). Examining the effect of perceived
service quality of health care delivery in Ghana on behavioural intentions of
patients: The mediating role of customer satisfaction. International Journal of
Healthcare