Comparing Alternative Methods of Measuring Geographic Access to Health Services: An Assessment of People’s Access to Specialist Hospital in Kebbi State

This paper presents comprehensive and analytical methodologies of Geographical Information Systems (GIS) in identifying geographic access to health service provision. It compares some alternative measures of geographic access to health care facility using spatial analysis. ArcGIS based network analysis (Origin and Destination Cost Matrix) was used to denote Output areas as the origin (demand) and hospital as the destination (supply). Raster based straight line distances (Euclidean) for same area was measured to identify this access. The accessibility of people within 60 km, 100 km, 200 km, 250 km and distances ? 300 km were assessed for both methods. The results for OD matrix stood at 29.77% (60 km), 42.48% (100 km), 53.78% (200 km), 72.99% (250 km) and 30.38% (? 300 km) whereas, for the straight line distance, 39.99% (60 km), 57.35% (100 km), 75.52% (200 km), 83.67% (250 km) and 0.0% (? 300 km) were recorded. The distance measurements were statistically not very strong (p- 0.07) between the methods. Moreover, travel time was also modelled at speed limit 50 km per hour using OD Matrix. The result indicates that only 33.35% are within drive time of 80 minutes (1 hr. 20 min.) and over 30% are within drive time ? 2 hrs. 45 min. Thus, the study encourages the use of OD Matrix in facility location analysis being more promising than the Euclidean model. The paper also strongly recommend to policy makers in the health service to embrace GIS to incorporate the technology of how service areas of health servers can be used as a basis for better use of population health service ratios to ensure equitable distribution of resources and effective health care delivery.