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Physical access to primary health care in Andean Bolivia

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  • Perry, Baker
  • Gesler, Wil

Abstract

Limited physical access to primary health care is a major factor contributing to the poor health of populations in developing countries, particularly in mountain areas with rugged topography, harsh climates and extensive socioeconomic barriers. Assessing physical access to primary health care is an important exercise for health care planners and policy makers. The development of geographic information system (GIS) technology has greatly improved this assessment process in industrialized countries where digital cartographic data are widely available. In developing countries -- particularly in mountain areas, however, detailed cartographic data, even in hardcopy form, are nonexistent, inaccurate or severely lacking. This paper uses GIS technology to assess physical access to primary health care in a remote and impoverished region of Andean Bolivia. In addition, it proposes an alternative model of health personnel distribution to maximize physical accessibility. Methods involved extensive fieldwork in the region, utilizing GPS (global positioning system) technology in the development of the GIS and gathering other pertinent health data for the study. Satellite imagery also contributed to the development of the GIS and in the modeling process. The results indicate significant variation in physical access to primary health care across the three study sites. More importantly, this paper highlights the use of GIS technology as a powerful tool in improving physical accessibility in mountain areas of developing countries.

Suggested Citation

  • Perry, Baker & Gesler, Wil, 2000. "Physical access to primary health care in Andean Bolivia," Social Science & Medicine, Elsevier, vol. 50(9), pages 1177-1188, May.
  • Handle: RePEc:eee:socmed:v:50:y:2000:i:9:p:1177-1188
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    Cited by:

    1. Irene Casas & Eric Delmelle & Alejandro Varela, 2010. "A Space-Time Approach to Diffusion of Health Service Provision Information," International Regional Science Review, , vol. 33(2), pages 134-156, April.
    2. Johns, Benjamin & Steinhardt, Laura & Walker, Damian G. & Peters, David H. & Bishai, David, 2013. "Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach," Social Science & Medicine, Elsevier, vol. 89(C), pages 25-31.
    3. John Gibson & David McKenzie, 2007. "Using Global Positioning Systems in Household Surveys for Better Economics and Better Policy," The World Bank Research Observer, World Bank Group, vol. 22(2), pages 217-241, September.
    4. Banick, Robert & Heyns, Andries M. & Regmi, Suraj, 2021. "Evaluation of rural roads construction alternatives according to seasonal service accessibility improvement using a novel multi-modal cost-time model: A study in Nepal's remote and mountainous Karnali," Journal of Transport Geography, Elsevier, vol. 93(C).
    5. Yao, Jing & Murray, Alan T. & Agadjanian, Victor, 2013. "A geographical perspective on access to sexual and reproductive health care for women in rural Africa," Social Science & Medicine, Elsevier, vol. 96(C), pages 60-68.
    6. Deshpande, Kirti & RaviShankar & Diwan, Vishal & Lonnroth, Knut & Mahadik, Vijay Kumar & Chandorkar, Ram Krishna, 2004. "Spatial pattern of private health care provision in Ujjain, India: a provider survey processed and analysed with a Geographical Information System," Health Policy, Elsevier, vol. 68(2), pages 211-222, May.
    7. Murawski, Lisa & Church, Richard L., 2009. "Improving accessibility to rural health services: The maximal covering network improvement problem," Socio-Economic Planning Sciences, Elsevier, vol. 43(2), pages 102-110, June.
    8. John Gibson & Xiangzheng Deng & Geua Boe-Gibson & Scott Rozelle & Jikun Huang, 2008. "Which Households Are Most Distant from Health Centers in Rural China? Evidence from a GIS Network Analysis," Working Papers in Economics 08/19, University of Waikato.
    9. Lila C. Fleming & Rashid Ansumana & Alfred S. Bockarie & Joel D. Alejandre & Karen K. Owen & Umaru Bangura & David H. Jimmy & Kevin M. Curtin & David A. Stenger & Kathryn H. Jacobsen, 2016. "Health-care availability, preference, and distance for women in urban Bo, Sierra Leone," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(9), pages 1079-1088, December.
    10. Tanser, Frank & Gijsbertsen, Brice & Herbst, Kobus, 2006. "Modelling and understanding primary health care accessibility and utilization in rural South Africa: An exploration using a geographical information system," Social Science & Medicine, Elsevier, vol. 63(3), pages 691-705, August.
    11. John Gibson & David McKenzie, 2007. "Using Global Positioning Systems in Household Surveys for Better Economics and Better Policy," The World Bank Research Observer, World Bank Group, vol. 22(2), pages 217-241, September.
    12. Benjamin Johns & Rob Baltussen, 2004. "Accounting for the cost of scalingā€up health interventions," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1117-1124, November.
    13. Zhenbao Wang & Dong Liu & Shihao Li & Shuyue Liu & Huiqing Li & Ning Chen, 2023. "Analyzing the Impact of Decreasing Out-of-Vehicle Time of Public Transportation Travel on Accessibility to Tertiary Hospitals," Sustainability, MDPI, vol. 15(16), pages 1-20, August.
    14. Panelli, Ruth & Gallagher, Lou & Kearns, Robin, 2006. "Access to rural health services: Research as community action and policy critique," Social Science & Medicine, Elsevier, vol. 62(5), pages 1103-1114, March.
    15. Unal, Eda & Chen, Susan E. & Waldorf, Brigitte S., 2007. "Spatial Accessibility Of Health Care In Indiana," Working papers 7329, Purdue University, Department of Agricultural Economics.
    16. Firat Bilgel & Burhan Can Karahasan, 2017. "Self-Rated Health and Primary Care Utilization: Is Selection into Healthcare Endogenously Determined?," Working Papers 1079, Economic Research Forum, revised 04 Jun 2017.
    17. Neutens, Tijs, 2015. "Accessibility, equity and health care: review and research directions for transport geographers," Journal of Transport Geography, Elsevier, vol. 43(C), pages 14-27.
    18. Ge Lin & Diane E Allan & Margaret J Penning, 2002. "Examining Distance Effects on Hospitalizations Using GIS: A Study of Three Health Regions in British Columbia, Canada," Environment and Planning A, , vol. 34(11), pages 2037-2053, November.

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    Keywords

    Primary health care Bolivia GIS;

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