An assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeria

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dc.contributor.authorBanke-Thomas, A.
dc.contributor.authorWong, k.L.M.
dc.contributor.authorCollins, L.
dc.contributor.authorOlaniran, A.
dc.contributor.authorBalogun, M.
dc.contributor.authorWright, O.
dc.contributor.authorBabajide, O.
dc.contributor.authorAjayi, B.
dc.contributor.authorAfolabi, B.B.
dc.contributor.authorAbayomi, A.
dc.contributor.authorBenova, L.
dc.date.accessioned2021-12-08T13:48:07Z
dc.date.available2021-12-08T13:48:07Z
dc.date.issued2021-10
dc.descriptionScholarly articlesen_US
dc.description.abstractPrevious efforts to estimate the travel time to comprehensive emergency obstetric care (CEmOC) in low- and middle-income countries (LMICs) have either been based on spatial models or self-reported travel time, both with known inaccuracies. The study objectives were to estimate more realistic travel times for pregnant women in emergency situations using Google Maps, determine system-level factors that influence travel time and use these estimates to assess CEmOC geographical accessibility and coverage in Lagos state, Nigeria. Data on demographics, obstetric history and travel to CEmOC facilities of pregnant women with an obstetric emergency, who presented between 1st November 2018 and 31st December 2019 at a public CEmOC facility were collected from hospital records. Estimated travel times were individually extracted from Google Maps for the period of the day of travel. Bivariate and multivariate analyses were used to test associations between travel and health system-related factors with reaching the facility >60 minutes. Mean travel times were compared and geographical coverage mapped to identify 'hotspots' of predominantly >60 minutes travel to facilities. For the 4005 pregnant women with traceable journeys, travel time ranges were 2-240 minutes (without referral) and 7-320 minutes (with referral). Total travel time was within the 60 and 120 minute benchmark for 80 and 96% of women, respectively. The period of the day of travel and having been referred were significantly associated with travelling >60 minutes. Many pregnant women living in the central cities and remote towns typically travelled to CEmOC facilities around them. We identified four hotspots from which pregnant women travelled >60 minutes to facilities. Mean travel time and distance to reach tertiary referral hospitals were significantly higher than the secondary facilities. Our findings suggest that actions taken to address gaps need to be contextualized. Our approach provides a useful guide for stakeholders seeking to comprehensively explore geographical inequities in CEmOC access within urban/peri-urban LMIC settings.en_US
dc.identifier.citationBanke-Thomas A, Wong KLM, Collins L, Olaniran A, Balogun M, Wright O, Babajide O, Ajayi B, Afolabi BB, Abayomi A, Benova L. An assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeria. Health Policy Plan. 2021 Oct 12;36(9):1384-1396. doi: 10.1093/heapol/czab099. PubMed PMID: 34424314; PubMed Central PMCID: PMC8505861.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/9793
dc.language.isoenen_US
dc.publisherHealth Policy Planen_US
dc.subjectLagosen_US
dc.subjectMaternal healthen_US
dc.subjectNigeriaen_US
dc.subjectAccessibilityen_US
dc.subjectCare-seekingen_US
dc.subjectEmergency obstetric careen_US
dc.subjectGeographical coverageen_US
dc.subjectReferralen_US
dc.subjectTravelen_US
dc.subjectUniversal health coverageen_US
dc.subjectUrbanen_US
dc.subjectResearch Subject Categories::MEDICINE::Surgery::Obstetrics and women's diseases::Obstetrics and gynaecologyen_US
dc.titleAn assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeriaen_US
dc.typeArticleen_US
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