Application d'outils d'analyse spatiale pour évaluer la dynamique d'utilisation des établissements de santé publics dans le nord du Botswana

Application of spatial analysis tools to assess the dynamics in utilization of public health facilities in northern Botswana

Abstract

Generally, there is a high flow of patients to certain public healthcare facilities compared to those otherwise within their threshold accessible reach in Botswana. This results in overburdening of those facilities having an influx of patients from outside their respective catchment areas. However, public health facilities are accessibly placed within the communities they serve, which make it difficult to understand why some public health facilities are preferred over others. Therefore, the objective of this research is to assess the geospatial dynamics in utilization of public health facilities in Maun. Purposive sampling technique was used to select 4 out of 11 public health facilities in Maun across the 6tier system in Botswana. A total of 30 households were randomly selected around the chosen healthcare facilities for primary data collection using a questionnaire to capture the dynamics in public healthcare usage. Geographic locations of the chosen facilities and households were recorded using a GPS. Additionally, secondary quarterly patient flow data was collected from the respective facilities. A distance measurement tool was used to determine the travel distance to health facilities utilized by the households. The Kernel density was used to identify the hotspot public health facility in Maun. It was found that the levels of preference for public health facilities decline as one goes down the tier system. The study revealed that facilities are located within patients’ accessible reach in Maun as most can be reached by walking and the average travel distance to facilities was 5.45 kilometers, safely within WHO threshold of 8 kilometers. Graduated symbols representation revealed the healthcare facility with high frequency of
visitation or degree of preference by our respondents. And Letsholathebe II Memorial Hospital is the hotspot
healthcare facility in Maun based on the number of patients that utilize it, which is clearly revealed by results from Kernel Density. This study provides a synopsis on the geospatial dynamics in utilization of public healthcare in Botswana, which is a paramount contribution to decision-making for a sound distribution of health centers in the country and beyond.