Delineating natural catchment health districts with routinely collected health data from women's travel to give birth in Ghana
Delineating natural catchment health districts with routinely collected health data from women's travel to give birth in Ghana
Background
Health service areas are essential for planning, policy and managing public health interventions. In this study, we delineate health service areas from routinely collected health data as a robust geographic basis for presenting access to maternal care indicators.
Methods
A zone design algorithm was adapted to delineate health service areas through a cross-sectional, ecological study design. Health sub-districts were merged into health service areas such that patient flows across boundaries were minimised. Delineated zones and existing administrative boundaries were used to provide estimates of access to maternal health services. We analysed secondary data comprising routinely collected health records from 32,921 women attending 27 hospitals to give birth, spatial demographic data, a service provision assessment on the quality of maternal healthcare and health sub-district boundaries from Eastern Region, Ghana.
Results
Clear patterns of cross border movement to give birth emerged from the analysis, but more women originated closer to the hospitals. After merging the 250 sub-districts in 33 districts, 11 health service areas were created. The minimum percent of internal flows of women giving birth within any health service area was 97.4%. Because the newly delineated boundaries are more "natural" and sensitive to observed flow patterns, when we calculated areal indicator estimates, they showed a marked improvement over the existing administrative boundaries, with the inclusion of a hospital in every health service area.
Conclusion
Health planning can be improved by using routine health data to delineate natural catchment health districts. In addition, data-driven geographic boundaries derived from public health events will improve areal health indicator estimates, planning and interventions.
Geographic information systems, Health catchment areas, Health information systems, Health services accessibility, Health systems plans, Maternal health services
772
Dotse-Gborgbortsi, Winfred
02d3e356-268e-4650-9fb9-9638ccdb6eff
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Alegana, Victor A.
f5bd6ab7-459e-4122-984f-2bdb5f906d82
Ofosu, Anthony
32461b6f-8de7-4289-bd29-923f9f042d53
Wright, Jim
94990ecf-f8dd-4649-84f2-b28bf272e464
13 June 2022
Dotse-Gborgbortsi, Winfred
02d3e356-268e-4650-9fb9-9638ccdb6eff
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Alegana, Victor A.
f5bd6ab7-459e-4122-984f-2bdb5f906d82
Ofosu, Anthony
32461b6f-8de7-4289-bd29-923f9f042d53
Wright, Jim
94990ecf-f8dd-4649-84f2-b28bf272e464
Dotse-Gborgbortsi, Winfred, Tatem, Andrew, Matthews, Zoe, Alegana, Victor A., Ofosu, Anthony and Wright, Jim
(2022)
Delineating natural catchment health districts with routinely collected health data from women's travel to give birth in Ghana.
BMC Health Services Research, 22 (1), , [772].
(doi:10.1186/s12913-022-08125-9).
Abstract
Background
Health service areas are essential for planning, policy and managing public health interventions. In this study, we delineate health service areas from routinely collected health data as a robust geographic basis for presenting access to maternal care indicators.
Methods
A zone design algorithm was adapted to delineate health service areas through a cross-sectional, ecological study design. Health sub-districts were merged into health service areas such that patient flows across boundaries were minimised. Delineated zones and existing administrative boundaries were used to provide estimates of access to maternal health services. We analysed secondary data comprising routinely collected health records from 32,921 women attending 27 hospitals to give birth, spatial demographic data, a service provision assessment on the quality of maternal healthcare and health sub-district boundaries from Eastern Region, Ghana.
Results
Clear patterns of cross border movement to give birth emerged from the analysis, but more women originated closer to the hospitals. After merging the 250 sub-districts in 33 districts, 11 health service areas were created. The minimum percent of internal flows of women giving birth within any health service area was 97.4%. Because the newly delineated boundaries are more "natural" and sensitive to observed flow patterns, when we calculated areal indicator estimates, they showed a marked improvement over the existing administrative boundaries, with the inclusion of a hospital in every health service area.
Conclusion
Health planning can be improved by using routine health data to delineate natural catchment health districts. In addition, data-driven geographic boundaries derived from public health events will improve areal health indicator estimates, planning and interventions.
Text
Delineating health districts_v6_bmchsr_submitted_revised_WD_pure_uplaod
- Accepted Manuscript
More information
Accepted/In Press date: 26 May 2022
Published date: 13 June 2022
Additional Information:
Funding Information:
This work was supported by the Economic and Social Research Council [grant number ES/P000673/1]. VA is supported by a Wellcome Trust Fellowship [number 211208]. We are thankful to the Ghana Health Service for making routine health data available and supporting service provision assessment surveys.
Funding Information:
This work was supported by the Economic and Social Research Council [grant number ES/P000673/1]. VA is supported by a Wellcome Trust Fellowship [number 211208]. We are thankful to the Ghana Health Service for making routine health data available and supporting service provision assessment surveys.
Publisher Copyright:
© 2022, The Author(s).
Keywords:
Geographic information systems, Health catchment areas, Health information systems, Health services accessibility, Health systems plans, Maternal health services
Identifiers
Local EPrints ID: 458173
URI: http://eprints.soton.ac.uk/id/eprint/458173
ISSN: 1472-6963
PURE UUID: b891f326-4d3f-40ba-85f2-827b544ec083
Catalogue record
Date deposited: 30 Jun 2022 16:36
Last modified: 10 Apr 2024 02:12
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Contributors
Author:
Winfred Dotse-Gborgbortsi
Author:
Anthony Ofosu
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