AI Article Synopsis

  • Health planners often focus on geographic proximity to assess access to health services, but effective access also relies on having trained providers and adequate supplies.
  • A study in Malawi, Mali, and Zambia revealed that while 43% of the population had geographic access to health services, effective access dropped to only 14%.
  • Implementing community case management (CCM) significantly improved access, potentially increasing effective access to between 30-57% if trained providers and necessary supplies were ensured.

Article Abstract

Health planners commonly use geographic proximity to define access to health services. However, effective access to case management requires reliable access to a trained, supplied provider. We defined effective access as the proportion of the study population with geographic access, corrected for other barriers, staffing patterns, and medicine availability. We measured effective access through a cross-sectional survey of 32 health facilities in Malawi, Mali, and Zambia and modeled the potential contribution of community case management (CCM). The population living within Ministry of Health (MOH)-defined geographic access was 43% overall (range = 18-52%), but effective access was only 14% overall (range = 9-17%). Implementing CCM as per MOH plans increased geographic access to 63-90% and effective access to 30-57%. Access to case management is much worse than typically estimated by distance. The CCM increases access dramatically, again if providers are available and supplied, and should be considered even for those within MOH-defined access areas.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748526PMC
http://dx.doi.org/10.4269/ajtmh.2012.11-0747DOI Listing

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