Assessment of primary healthcare accessibility and inequality in north-eastern Kazakhstan

Submitted: 4 October 2021
Accepted: 25 January 2022
Published: 13 May 2022
Abstract Views: 1672
PDF: 679
HTML: 192
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Out of the many aspects of health care, the concept of physical accessibility is a priority that not only encompasses availability of health care resources, but also requires that they are easily accessible for all. To assess this factor as expressed in terms of the number of available physicians in the north-eastern part of Kazakhstan, we used the enhanced two-step float catchment area in a geographic information system approach. The Gini index and the Lorentz curve were used to evaluate the economic inequality within this region. Based on the data obtained, we developed models to increase the availability of health care considering allocation of additional primary health care resources. A low to zero index was found to be typical for most rural settlements, which currently make up less than 15% of the total population. We also identified a correlation between the index of accessibility and that of inequality, which indicates that areas with high accessibility show a more equitable distribution of resources. The developed location/ allocation models of additional primary health care resources can be useful in implementing government initiatives to improve the availability of primary health care in rural areas.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Abdelkarim A, 2019. Integration of location-allocation and accessibility models in GIS to improve urban planning for health services in Al-Madinah Al-Munawwarah, Saudi Arabia. J Geogr Inf Syst 11:633-62. DOI: https://doi.org/10.4236/jgis.2019.116039
Black M, Ebener S, Aguilar PN, Vidaurre M, El Morjani Z, 2004. Using GIS to measure physical accessibility to health care. Esri’s 2004 Esri International Health GIS Conference Proceedings, October 17-20, Washington, D.C., 22 pages. Available from: https://proceedings.esri.com/library/userconf/health04/papers/pap3023.pdf Accessed: May 2, 2021.
Bryant J, Delamater PL, 2019. Examination of spatial accessibility at micro- and macro-levels using the enhanced two-step floating catchment area (E2SFCA) method. Ann GIS 25:219-29. DOI: https://doi.org/10.1080/19475683.2019.1641553
Cousineau D, Chartier S, 2010. Outliers detection and treatment: a review. Int J Psychol Stud 3:58-67. DOI: https://doi.org/10.21500/20112084.844
Deborah OML, Chiu MYL, Cao K, 2018. Geographical accessibility of community health assist scheme general practitioners for the elderly population in Singapore: a case study on the elderly living in housing development board flats. Int J Environ Res Public Health 15:1988. DOI: https://doi.org/10.3390/ijerph15091988
Donohoe J, Marshall V, Tan X, Camacho FT, Anderson RT, Balkrishnan R, 2016. Spatial access to primary care providers in appalachia: evaluating current methodology. J Prim Care Community Health 7:149-58. DOI: https://doi.org/10.1177/2150131916632554
El Karim A, Awawdeh, 2020. Integrating GIS accessibility and location-allocation models with multicriteria decision analysis for evaluating quality of life in Buraidah city, KSA. Sustainability 12:1412. DOI: https://doi.org/10.3390/su12041412
Evans DB, Hsu J, Boerma T, 2013. Universal health coverage and universal access. Bull World Health Organ 91:546-46Ð. DOI: https://doi.org/10.2471/BLT.13.125450
Government of Kazakhstan, 2021. Government considers measures to develop primary health care - Official Information Source of the Prime Minister of the Republic of Kazakhstan. Available from: https://www.primeminister.kz/en/news/pravitelstvo-rassmotrelo-mery-po-razvitiyu-pervichnoy-mediko-sanitarnoy-pomoshchi-222140 Accessed: May 26, 2021.
Hashtarkhani S, Kiani B, BergquistR, Bagheri N, Vafaei Nejad R, Tara M, 2020. An age-integrated approach to improve measurement of potential spatial accessibility to emergency medical services for urban areas. Int J Health Plan Manag 35:788-98. DOI: https://doi.org/10.1002/hpm.2960
Health ministry of Kazakhstan, 2018. In half a year, more than 9 million people received primary health care services - Ministry of Healthcare - Official Information Source of the Prime Minister of the Republic of Kazakhstan. Available from: https://www.primeminister.kz/en/17078 Accessed: May 26, 2021.
Hoseini B, Bagheri N, Kiani B, Azizi A, Tabesh H, Tara M, 2018. Access to dialysis services: A systematic mapping review based on geographical information systems. Geospat Health 13:3-10. DOI: https://doi.org/10.4081/gh.2018.577
Jamtsho S, Corner R, Dewan A, 2015. Spatio-temporal analysis of spatial accessibility to primary health care in Bhutan. ISPRS Int J Geoinf 4:1584-604. DOI: https://doi.org/10.3390/ijgi4031584
Jarman B, 1983. Identification of underprivileged areas. Br Med J (Clin Res Ed) 286:1705-9. ì DOI: https://doi.org/10.1136/bmj.286.6379.1705
Jordan H, Roderick P, Martin D, Barnett S, 2004. Distance, rurality and the need for care: Access to health services in South West England. Int J Health Geogr 3:1-9. DOI: https://doi.org/10.1186/1476-072X-3-21
Kanuganti S, Sarkar A, Singh A, 2016. Quantifying accessibility to health care using two-step floating catchment area method (2SFCA): a case study in Rajasthan. Transp Res Procedia 17:391-9. DOI: https://doi.org/10.1016/j.trpro.2016.11.080
Khan A, 1992. An integrated approach to measuring potential spatial access to health care services. Socio-Econ Plan Sci 26:275-87. DOI: https://doi.org/10.1016/0038-0121(92)90004-O
Kiani B, Bagheri N, Tara A, Hoseini B, Tabesh H, Tara M, 2017. Revealed access to haemodialysis facilities in northeastern Iran: factors that matter in rural and urban areas. Geospat Health 12:237-44. DOI: https://doi.org/10.4081/gh.2017.561
Kiani B, Mohammadi A, Bergquist R, Bagheri N, 2021. Different configurations of the two-step floating catchment area method for measuring the spatial accessibility to hospitals for people living with disability: a cross-sectional study. Arch Public Health 79:1-10. DOI: https://doi.org/10.1186/s13690-021-00601-8
Kuldeep, Banu V, Uniyal S, Nagaraja R, 2017. Space based inputs for health service development planning in rural areas using GIS. Geod Cartogr 43:28-34. DOI: https://doi.org/10.3846/20296991.2017.1302049
Langford M, Fry R, Higgs G, 2012. Measuring transit system accessibility using a modified two-step floating catchment technique. Int J Geogr Inf Syst 26:193-214. DOI: https://doi.org/10.1080/13658816.2011.574140
Langford M, Higgs G, Dallimore D, 2019. Investigating spatial variations in access to childcare provision using network-based GIS models. Social Policy Admin 53:661-77. DOI: https://doi.org/10.1111/spol.12419
Lorenz MO, 1905. Methods of measuring the concentration of wealth. J Am Stat Assoc 9:209-19. DOI: https://doi.org/10.2307/2276207
Luo J, Tian L, Luo L, Yi H, Wang F, 2017. Two-step optimization for spatial accessibility improvement: a case study of health care planning in Rural China. Biomed Res Int 2017: 2094654. DOI: https://doi.org/10.1155/2017/2094654
Luo W, Qi Y, 2009. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health Place 15:1100-7. DOI: https://doi.org/10.1016/j.healthplace.2009.06.002
Luo W, Wang F, 2003. Measures of spatial accessibility to health care in a GIS environment: Synthesis and a case study in the Chicago region. Environ Plann B Plann Des 30:865-84. DOI: https://doi.org/10.1068/b29120
Luo W, Whippo T, 2012. Variable catchment sizes for the two-step floating catchment area (2SFCA) method. Health Place 18:789-95. DOI: https://doi.org/10.1016/j.healthplace.2012.04.002
Mao K, Li M, Huang Q, Chen C, Hu W, Chen D, 2011. Evaluation of spatial accessibility to town and rural in a GIS environment: a case study of Dachang County. Proceedings 19th International Conference on Geoinformatics. GeoInformatics 2011:5980675. DOI: https://doi.org/10.1109/GeoInformatics.2011.5980675
McGrail MR, 2012. Spatial accessibility of primary health care utilising the two step floating catchment area method: an assessment of recent improvements. Int. J. Health Geogr 11:1-12. DOI: https://doi.org/10.1186/1476-072X-11-50
McGrail MR, Humphreys JS, 2009. The index of rural access: An innovative integrated approach for measuring primary care access. BMC Health Serv Res 9:1-12. DOI: https://doi.org/10.1186/1472-6963-9-124
Mohammadi A, Mollalo A, Bergquist R, Kiani B, 2021. Measuring COVID-19 vaccination coverage: an enhanced age-adjusted two-step floating catchment area model. Infect Dis Poverty 10:1-13. DOI: https://doi.org/10.1186/s40249-021-00904-6
MoH of the Republic of Kazakhstan order, 2020. On the approval of the minimum standards for the provision of regions with medical workers. Available from: https://adilet.zan.kz/rus/docs/V2000021679 Accessed: October 26, 2021.
Özceylan E, Uslu A, Erbaş M, Çetinkaya C, İşleyen K, 2017. Optimizing the location-allocation problem of pharmacy warehouses: a case study in Gaziantep. Int J Optim Control Theor Appl 7:117-29. DOI: https://doi.org/10.11121/ijocta.01.2017.00373
Penchansky R, Thomas JW, 1981. The concept of access: definition and relationship to consumer satisfaction. Med Care 19:127-40. DOI: https://doi.org/10.1097/00005650-198102000-00001
Population census of Kazakhstan, 2010. Available from: https://stat.gov.kz/census/national/2009 Accessed: May 26, 2021.
Price A, Langford M, Higgs G, 2021. Computing geographical access to services: the design of a client-server solution that incorporates multiple transport modes. Trans GIS 00:1-19.
WHO, 2019. Primary Health Care on the Road to Universal Health Coverage 2019 - Global monitoring report executive summary. Available from: http://apps.who.int/bookorders Accessed: October 26, 2021.
R Core Team, 2016. R: A Language and Environment for Statistical Computing, Vienna, Austria. Available from: https://www.R-project.org/ Accessed: October 26, 2021.
Robertson JS, Davies JA, 1978. Declaration of Alma-Ata (letter to the Editor). Lancet 312:1144. DOI: https://doi.org/10.1016/S0140-6736(78)92291-2
Shabanikiya H, Hashtarkhani S, Bergquist R, Bagheri N, VafaeiNejad R, Amiri-Gholanlou M, Akbari T, Kiani B, 2020. Multiple-scale spatial analysis of paediatric, pedestrian road traffic injuries in a major city in North-Eastern Iran 2015-2019. BMC Public Health 20:1-11. DOI: https://doi.org/10.1186/s12889-020-08911-2
Subal J, Paal P, Krisp JM, 2021. Quantifying spatial accessibility of general practitioners by applying a modified huff three-step floating catchment area (MH3SFCA) method. Int J Health Geogr 20:1-14. DOI: https://doi.org/10.1186/s12942-021-00263-3
Tao Y, Henry K, Zou Q, 2014. Methods for measuring horizontal equity in health resource allocation: a comparative study. Health Econ Rev 4:10. DOI: https://doi.org/10.1186/s13561-014-0010-x
Tao Z, Cheng Y, Zheng Q, Li G, 2018. Measuring spatial accessibility to healthcare services with constraint of administrative boundary: a case study of Yanqing District, Beijing, China. Int J Equity Health 17:1-12. DOI: https://doi.org/10.1186/s12939-018-0720-5
Townsend P, Phillimore P, Beattie A, 1988. Health Policy. pp 206-7 in Health and Deprivation: Inequality and the North. Croom Helm, Bristol, UK.
UN, 2013. Resolution adopted by the General Assembly on 12 December 2012 67/81 - Global health and foreign policy. Available from: https://undocs.org/en/A/RES/67/81 Accessed: May 26, 2021.
Wang F, 2020. Why public health needs GIS: a methodological overview. Ann GIS 26:1-12. DOI: https://doi.org/10.1080/19475683.2019.1702099

How to Cite

Shaltynov, A., Rocha , J., Jamedinova, U., & Myssayev, A. (2022). Assessment of primary healthcare accessibility and inequality in north-eastern Kazakhstan. Geospatial Health, 17(1). https://doi.org/10.4081/gh.2022.1046

List of Cited By :

Crossref logo