Patricia Nájera-Aguilar, MA Geography¹, Carlos Castillo-Salgado, MD, DrPH², Manuel Vidaurre-Arenas, MSc¹, Ramón Martinez-Piedra, Inf System Eng¹, and Enrique Loyola, MD, MSc¹. (1) Area of Health Analysis and Information Systems, Pan American Health Organization/ World Health Org./UN, 525 23rd.St NW, Room 602A, Washington, DC 20037, 2029743192, najerapa@paho.org, (2) Special Program for Health Analysis, Pan American Health Organization, 525 23rd Street, N. W., Washington, DC 20037

Honduras’ Ministry of Health, along with the Pan American Health Organization (PAHO), intends to distinguish accessibility problems to primary health care (PHC) using Geographic Information Systems (GIS), with the purpose of restructuring health resources for disadvantaged populations. In 2001, rural communities were served by 216 health centers (CESAMO) with PHC teams (physician, dentist, nurse). Scenarios of critical accessibility areas and unmet basic needs were examined. Geographical coverage was measured with Thiessen polygons to establish nearest health facilities. An accessibility index (AI) was estimated by adding up z scores of distances and terrain slopes amid villages, roads and CESAMO. Specific key indicators are distances and slopes to nearest PHC facility, distances and slopes from adjacent paved roads, as well as villages surrounding gradients. Slopes values were calculated processing the Honduran Digital Elevation Model (DEM) into a Triangulated Irregular Network (TIN) and subsequently, assigned to roads, trajectories and villages. AI's Inverse Distance Weight (IDW) contouring over 2 Standard Deviations (SD) defined critical areas. Results showed that more than 500,000 people (9% of Hondurans) reside in critical accessibility areas: remote and hilly places where there’re just 38 rural health centers (CESAR) with nurses only ; besides three closed CESAMOs. Accessibility assessment strengthens recognition of unmet needs and improves planning process for resources re-allocation in alternative coverage scenarios. Additional analysis is suggested to include transportation network and land use impact on health services distribution.

Learning Objectives:

• Identify how geographic analysis and GIS help to recognize low accessibility to PHC using geo-referred data on health infrastructure, population’s relative location and environmental conditions.

Keywords: Access to Health Care, Information Systems

Related Web page: www.ais.paho.org/sigepi

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.