Chowdhury Mahbub E, Biswas Taposh K, Rahman Monjur, Pasha Kamal, Hossain Mollah A
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Center for Environmental and Geographic Information Services, Dhaka, Bangladesh.
Int J Gynaecol Obstet. 2017 Aug;138(2):164-170. doi: 10.1002/ijgo.12196. Epub 2017 May 23.
To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive).
A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks.
The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower.
Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems.
运用地理信息系统（GIS）确定获得产科急诊和新生儿急救护理（EmONC）的医疗设施可达性，并将覆盖情况与联合国指南规定的情况（每50万人有5个EmONC设施，至少1个综合性设施）进行比较。
2012年3月至10月，对孟加拉国24个地区所有提供EmONC的公共设施进行了一项横断面研究。通过应用GIS评估每个设施的可达性，以估计现有道路网络分别在2小时和1小时行程时间内能够到达最近设施的集水区人口比例（综合性设施为50万；基本设施为10万）。
分别在16个和3个地区达到了提供综合性和基本EmONC服务的公共设施的最低数量（分别为每50万人1个和5个）。然而，应用GIS后，没有一个地区100%的集水区人口能够获得这些服务。分别在11个和5个地区至少有75%和50%的人口能够获得综合性服务。对于基本服务，可达性要低得多。
仅评估EmONC设施的数量并不能确保普遍覆盖；在规划卫生系统时应评估可达性。
