Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Public Health & Family Medicine, Division of Public Health Medicine, University of Cape Town, Cape Town, South Africa.
Int Health. 2022 May 2;14(3):260-270. doi: 10.1093/inthealth/ihab039.
This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources.
Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria. The location of all facilities was recorded using Global Positioning System and was subsequently mapped using ArcGIS software to produce spider-web diagrams displaying the spatial distribution of all health facilities.
The result of clustering analysis of health facilities shows that there is a statistically significant hotspot of health facility at 99% confidence located around the urban areas of Ibadan. The significant hotspot result is dominated by a feature with a high value and is surrounded by other features also with high values. Away from the urban built-up area of Ibadan, health facility clustering is not statistically significant. There was also a high level (94%) of bypassing of NHIS-accredited facilities among the enrollees.
Lopsided distribution of health facilities in the study area should be corrected as this may result in inequity of access to available health services.
本研究旨在评估尼日利亚国家健康保险计划（NHIS）下的地理空间分布和医疗设施可达性。研究结果将有助于高效规划和公平分配医疗资源。
在尼日利亚伊巴丹市收集了包括选定医疗设施分布在内的数据。使用全球定位系统记录所有设施的位置，然后使用 ArcGIS 软件将其映射，生成显示所有医疗设施空间分布的蛛网图。
对医疗设施聚类分析的结果表明，在 99%的置信水平下，伊巴丹市区周围存在一个具有统计学意义的医疗设施热点。显著热点结果主要由一个高值特征主导，周围是其他具有高值的特征。远离伊巴丹市区的建成区，医疗设施聚类没有统计学意义。在参保人群中，也有高达 94%的人绕过 NHIS 认证的医疗机构。
研究区域内医疗设施分布不均，应予以纠正，因为这可能导致可获得的卫生服务获取机会不平等。
