Locating sustainable community health facilities

Abstract

This thesis describes research into location analysis as part of the process of planning community health facilities for sustainability. We consider both the general context of hierarchical health facilities and also particular application to rural areas of developing countries. It is our widespread remit in both the developed and developing worlds that gives our research its unique nature, both in models produced and in discussion of their applicability. We begin with a discussion of the planning for sustainability of community health schemes in rural areas of developing countries, highlighting the merits of both ground-level considerations and top-down planning. We continue with details of our hierarchical models for location of health facilities. Our preliminary modelling is based on classical principles of location theory; this stage of modelling is developed into novel bicriteria efficiency/equity models with special relevance to rural areas of developing countries. We then present a case study of use of our efficiency/equity models for location of community health facilities in Leeds, UK. Finally, we analyse data collected from a community health centre in rural northern India, and describe a model for estimating uptake of a facility's services from a surrounding region.

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ORCID for H. Smith: orcid.org/0000-0002-4974-3011

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