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Physical access to primary health care in Andean Bolivia


  • Perry, Baker
  • Gesler, Wil


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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    References listed on IDEAS

    1. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
    2. Gerdtham, U. -G. & Johannesson, M. & Lundberg, L. & Isacson, D., 1999. "A note on validating Wagstaff and van Doorslaer's health measure in the analysis of inequalities in health," Journal of Health Economics, Elsevier, vol. 18(1), pages 117-124, January.
    3. Newbold, K. Bruce & Eyles, John & Birch, Stephen, 1995. "Equity in health care: Methodological contributions to the analysis of hospital utilization within Canada," Social Science & Medicine, Elsevier, vol. 40(9), pages 1181-1192, May.
    4. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
    5. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
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    Cited by:

    1. 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.
    2. John Gibson & David McKenzie, 2007. "Using the Global Positioning System (GPS) in Household Surveys For Better Economics and Better Policy," Working Papers in Economics 07/04, University of Waikato.
    3. Benjamin Johns & Rob Baltussen, 2004. "Accounting for the cost of scaling-up health interventions," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1117-1124.
    4. 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.
    5. Gibson, John & McKenzie, David, 2007. "Using the global positioning system in household surveys for better economics and better policy," Policy Research Working Paper Series 4195, The World Bank.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.

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