Planning for Health Infrastructure in Uganda: Where is the need?
Dr. Shuaib Lwasa
Department of Geography,
Makerere University, Uganda
lwasa_s@arts.mak.ac.ug
Health infrastructure in Uganda refers to the physical structure and supporting equipment established for provision of health services.
It usually involves a structure with facilities for different health service needs, equipment such as cold-chain facilities for storage, management and use in the provision of health services to the population. Health systems in Uganda are increasingly facing challenges of ensuring health care provision to the expanding population that is also disproportionately spatially distributed.
This is due to a number of factors including; population growth, uneven population distribution, transportation networks which have made some area to remote, human resource and the financial requirements for managing and provision of health services. Health service provision is one of the many basic location-based social services to be provided in-tandem with the spatial distribution of the population.
Planning for the provision of health infrastructure therefore requires quality information on where need exist and though all people in the country require health infrastructure within a given proximity, because of resource constraints, prioritization is indispensable. Prioritization of health service location would therefore consider several factors but most importantly the issue of where the greatest need exist. According to the National Health Policy, health infrastructure are to be established in various administrative units within 2 km reach by population in rural and urban areas.
The Uganda Bureau of Statistics (UBOS 2005) conducted a survey on social service access and the result indicates that the current health facility access is 69.6% by the rural population and 95.8% by the urban population within 5 km radius. This paper analyzes access to health facilities using the population gridding approach and combining it with location of health infrastructure facilities. The analysis is intended to enhance the understanding of location-based service analysis and provision of information for planning of health services.
Objectives and purpose of the study
The objective of this study was to spatially analyze health facility access by relating location and population. Specifically the study objectives included;
- To apply location-based analyzes of access to health facilities in Uganda
- To generate spatial information for visualization and support planning and delivery of health infrastructure.
- To demonstrate the use of geospatial information and techniques in provision of information required for planning and health service delivery
Methodology
GIS techniques are utilized to analyze health facility access in Uganda. Because population statistics is administrative based, this study used the Gridding approach to spatiallize population in the country.
This technique is more robust than administrative-based summarizes which do not depict where the population is located. Data was collected from secondary data sources of Population and housing census, spatial data sets (NFA) and the health infrastructure survey by Global Positioning System accomplished between 2000 and 2003. The grided population of Uganda at a resolution of 5 km2 (map 1) is utilized which spreads the national population in areas excluding water bodies (Uwe D. et. Al, 2001). Gridding was based on county administrative level since there has been little change in counties than district or lower level administrative units.
Data on health facility grades and type of ownership was collected during the survey. Geostatistical tools of analysis were also utilized to analyze the randomness of health infrastructure locations within the grids.
This helped in enhancing the access by distance of health infrastructure by the population as well as the understanding of the spatial distribution of the facilities.