National and Subnational Estimates of Coverage and Travel Time to Emergency Obstetric Care in Afghanistan: Modeling of Spatial Accessibility

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Citation

Kim, Christine; Tappis, Hannah; McDaniel, Philip M.; Soroush, Mohammad Samim; Fried, Bruce J.; Weinberger, Morris; Trogdon, Justin G.; Kristen Hassmiller Lich; & Delamater, Paul L. (2020). National and Subnational Estimates of Coverage and Travel Time to Emergency Obstetric Care in Afghanistan: Modeling of Spatial Accessibility. Health & Place, 66, 102452. PMCID: PMC7773147

Abstract

In Afghanistan, the risk of maternal death is among the highest in the world, with wide variation across the country. One explanation may be wide geographic disparities in access and use of maternal health care services. This study describes the spatial distribution of public facilities providing maternal health care in Afghanistan, specifically emergency obstetric care (EmOC), and the differences in travel time estimates using different transportation modes from 2010 to 2015 at the national and subnational levels. We conducted mapping and spatial analyses to measure the proportion of pregnant women able to access any EmOC health facility within 2 h by foot, animal, motor vehicle and a combination of transport modes. In 2015, adequate coverage of active public health facilities within 2 h of travel time was 36.6% by foot and 71.2% by a combination of transport modes. We found an 8.3% and 63.2% increase in access to EmOC facilities within 2 h of travel time by a combination of transport modes and by foot only, respectively, by 2015. Access to a combination of transportation options such as motor vehicles and animals may benefit pregnant women in reaching health facilities efficiently. Afghanistan made impressive gains in maternal healthcare access; despite these improvements, large disparities remain in geographic access by province and overall access to facilities is still poor.

URL

http://dx.doi.org/10.1016/j.healthplace.2020.102452

Reference Type

Journal Article

Year Published

2020

Journal Title

Health & Place

Author(s)

Kim, Christine
Tappis, Hannah
McDaniel, Philip M.
Soroush, Mohammad Samim
Fried, Bruce J.
Weinberger, Morris
Trogdon, Justin G.
Kristen Hassmiller Lich
Delamater, Paul L.

Article Type

Regular

PMCID

PMC7773147

Continent/Country

Afghanistan

Sex/Gender

Women

ORCiD

Delamater - 0000-0003-3627-9739
Hassmiller Lich - 0000-0002-3311-4202