GIS-Based Assessment of the Spatial Pattern, Accessibility and Utilization of Healthcare Facilities in Keffi LGA, Nasarawa State, Nigeria
Abstract
It has been observed that public policy on healthcare provision in Nigeria over the years addresses the distribution and spatial equity question mainly at the regional level while neglecting the distribution of such facilities within a given Local Government Area (LGA). This study, therefore, mapped and examined the pattern of, and accessibility to, the identified healthcare facilities (HCFs) in keffi LGA, and then assessed the level of their utilization. Using Global Positioning System (GPS) handheld receiver to geo-locate the identified HCFs across the 10 wards, the GIS software was used to create a database in ArcCatalog (ArcGIS). The spatial pattern was analyzed using the Average Nearest Neighbour Statistical Analysis (ANNSA) while the utilization of HCFs was assessed from 200 copies of questionnaires randomly distributed purposely to adult population made up of HCFs users and managers. The ANNSA reveals that with an Observed Mean Distance of 0.009957 Degrees, Expected Mean Distance of 0.008385 Degrees, Nearest Neighbor Ratio of 1.187494, a z-score of 1.682398, and a p-value of 0.092492, there is a less than 10% likelihood that the observed dispersed pattern of healthcare facilities could be the result of random chance. The study also revealed that Kofa Pada PHC is the most centrally located HCF in Keffi LGA with a 6km maximum distance to travel from the Centroid of Urban Keffi. The study further showed that cost effectiveness of health services is ranked 1st (66%) as one of the major factors responsible for the choice or utilization of HCFs in the study area. This is understandable as most of the facilities are government-owned and are usually subsidized for National Health Insurance Scheme (NHIS) card holders. On the average, 33.5% of the patients only need to move within less than 1km while 56% do travel between 1 and 5km to obtain medical services while only about 9.5% had to travel >5km. The non-availability of doct
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