Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya
Abstract Background Estimating accessibility gaps to essential health interventions helps to allocate and prioritize health resources. Access to blood transfusion represents an important emergency health requirement. Here, we develop geo-spatial models of accessibility and competition to blood trans...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | International Journal of Health Geographics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12942-023-00327-6 |
| _version_ | 1797853584753164288 |
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| author | Eda Mumo Nathan O. Agutu Angela K. Moturi Anitah Cherono Samuel K. Muchiri Robert W. Snow Victor A. Alegana |
| author_facet | Eda Mumo Nathan O. Agutu Angela K. Moturi Anitah Cherono Samuel K. Muchiri Robert W. Snow Victor A. Alegana |
| author_sort | Eda Mumo |
| collection | DOAJ |
| description | Abstract Background Estimating accessibility gaps to essential health interventions helps to allocate and prioritize health resources. Access to blood transfusion represents an important emergency health requirement. Here, we develop geo-spatial models of accessibility and competition to blood transfusion services in Bungoma County, Western Kenya. Methods Hospitals providing blood transfusion services in Bungoma were identified from an up-dated geo-coded facility database. AccessMod was used to define care-seeker’s travel times to the nearest blood transfusion service. A spatial accessibility index for each enumeration area (EA) was defined using modelled travel time, population demand, and supply available at the hospital, assuming a uniform risk of emergency occurrence in the county. To identify populations marginalized from transfusion services, the number of people outside 1-h travel time and those residing in EAs with low accessibility indexes were computed at the sub-county level. Competition between the transfusing hospitals was estimated using a spatial competition index which provided a measure of the level of attractiveness of each hospital. To understand whether highly competitive facilities had better capacity for blood transfusion services, a correlation test between the computed competition metric and the blood units received and transfused at the hospital was done. Results 15 hospitals in Bungoma county provide transfusion services, however these are unevenly distributed across the sub-counties. Average travel time to a blood transfusion centre in the county was 33 min and 5% of the population resided outside 1-h travel time. Based on the accessibility index, 38% of the EAs were classified to have low accessibility, representing 34% of the population, with one sub-county having the highest marginalized population. The computed competition index showed that hospitals in the urban areas had a spatial competitive advantage over those in rural areas. Conclusion The modelled spatial accessibility has provided an improved understanding of health care gaps essential for health planning. Hospital competition has been illustrated to have some degree of influence in provision of health services hence should be considered as a significant external factor impacting the delivery, and re-design of available services. |
| first_indexed | 2024-04-09T19:53:00Z |
| format | Article |
| id | doaj.art-6547ffe0ece4486bb5d7121b593ac61f |
| institution | Directory Open Access Journal |
| issn | 1476-072X |
| language | English |
| last_indexed | 2024-04-09T19:53:00Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Health Geographics |
| spelling | doaj.art-6547ffe0ece4486bb5d7121b593ac61f2023-04-03T05:39:26ZengBMCInternational Journal of Health Geographics1476-072X2023-03-0122111310.1186/s12942-023-00327-6Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western KenyaEda Mumo0Nathan O. Agutu1Angela K. Moturi2Anitah Cherono3Samuel K. Muchiri4Robert W. Snow5Victor A. Alegana6Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammeDepartment of Geomatic Engineering and Geospatial Information System (GEGIS), Jomo Kenyatta University of Agriculture and Technology (JKUAT)Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammePopulation Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammePopulation Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammePopulation Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammePopulation Health Unit, Kenya Medical Research Institute-Wellcome Trust Research ProgrammeAbstract Background Estimating accessibility gaps to essential health interventions helps to allocate and prioritize health resources. Access to blood transfusion represents an important emergency health requirement. Here, we develop geo-spatial models of accessibility and competition to blood transfusion services in Bungoma County, Western Kenya. Methods Hospitals providing blood transfusion services in Bungoma were identified from an up-dated geo-coded facility database. AccessMod was used to define care-seeker’s travel times to the nearest blood transfusion service. A spatial accessibility index for each enumeration area (EA) was defined using modelled travel time, population demand, and supply available at the hospital, assuming a uniform risk of emergency occurrence in the county. To identify populations marginalized from transfusion services, the number of people outside 1-h travel time and those residing in EAs with low accessibility indexes were computed at the sub-county level. Competition between the transfusing hospitals was estimated using a spatial competition index which provided a measure of the level of attractiveness of each hospital. To understand whether highly competitive facilities had better capacity for blood transfusion services, a correlation test between the computed competition metric and the blood units received and transfused at the hospital was done. Results 15 hospitals in Bungoma county provide transfusion services, however these are unevenly distributed across the sub-counties. Average travel time to a blood transfusion centre in the county was 33 min and 5% of the population resided outside 1-h travel time. Based on the accessibility index, 38% of the EAs were classified to have low accessibility, representing 34% of the population, with one sub-county having the highest marginalized population. The computed competition index showed that hospitals in the urban areas had a spatial competitive advantage over those in rural areas. Conclusion The modelled spatial accessibility has provided an improved understanding of health care gaps essential for health planning. Hospital competition has been illustrated to have some degree of influence in provision of health services hence should be considered as a significant external factor impacting the delivery, and re-design of available services.https://doi.org/10.1186/s12942-023-00327-6AccessibilitySpatial competitionBlood transfusionTravel timeEmergencyBungoma |
| spellingShingle | Eda Mumo Nathan O. Agutu Angela K. Moturi Anitah Cherono Samuel K. Muchiri Robert W. Snow Victor A. Alegana Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya International Journal of Health Geographics Accessibility Spatial competition Blood transfusion Travel time Emergency Bungoma |
| title | Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya |
| title_full | Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya |
| title_fullStr | Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya |
| title_full_unstemmed | Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya |
| title_short | Geographic accessibility and hospital competition for emergency blood transfusion services in Bungoma, Western Kenya |
| title_sort | geographic accessibility and hospital competition for emergency blood transfusion services in bungoma western kenya |
| topic | Accessibility Spatial competition Blood transfusion Travel time Emergency Bungoma |
| url | https://doi.org/10.1186/s12942-023-00327-6 |
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