Spatial modeling of health facility utilization by pregnant women in Kalomo district, Zambia
Everett, Lindsey L.
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Together, maternal and neonatal mortality rates account for more than four million deaths worldwide, with the overwhelming majority of fatalities occurring in sub-Saharan Africa. Ensuring pregnant women deliver at health facilities assisted by skilled birth attendants is considered a primary solution for improving the survival and health of both mothers and newborns. By employing spatial analysis tools, this study examines the availability of emergency obstetrical and neonatal care (EmONC) and accessibility of 31 health facilities in Kalomo district, Zambia. Only three facilities had EmONC available (two basic and one comprehensive) in Kalomo's two largest towns situated slightly over 40 kilometers (km) apart. Buffers surrounding the EmONC facilities include 11 centers and hospitals administering minimal levels of emergency delivery care, but fail to incorporate the other 60% ofthe district's medical centers. While primary and secondary road networks cover the majority of Kalomo's territory, isolated areas remain unserved by the transit system and 20% of health centers are located outside the boundaries of 5 km road buffers. Motorized ambulatory transport is available at only three health facilities located in the district's two largest towns. The clustered distribution of EmONC facilities in the most populated urban centers provides professional medical assistance for the immediate surrounding communities, but leaves the majority of the population who reside in rural settings without access to emergency delivery services. Results from this study are useful for examining, monitoring, and targeting the availability and accessibility ofhealth facilities in attempt to lower maternal and neonatal fatalities.
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