2023-09-28 14:46:10 +00:00
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abstract: 'Maternal mortality is a major problem in middle-income and low-income
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countries, and the availability and accessibility of healthcare
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facilities offering safe delivery is important in averting maternal
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deaths. Siaya County, in Kenya, has one of the highest maternal
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mortality rates in the country-far more than the national average. This
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study aimed to evaluate geographic access to health facilities offering
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delivery services in Siaya County. A mixed-methods approach
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incorporating geographic information system analysis and individual data
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from semi-structured interviews was used to derive travel time maps to
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facilities using different travel scenarios: AccessMod5 and ArcGIS were
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used for these tasks. The derived maps were then linked to georeferenced
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household survey data in a multilevel logistic regression model in R to
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predict the probability of expectant women delivering in a health
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facility. Based on the derived travel times, 26 per cent (13,140) and 67
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per cent (32,074) of the estimated 46,332 pregnant women could reach any
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facility within one and two hours, respectively, while walking with the
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percentage falling to seven per cent (3,415) and 20 per cent (8,845)
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when considering referral facilities. Motorised transport significantly
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increased coverage. The findings revealed that the predicted probability
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of a pregnant woman delivering in a health facility ranged between 0.14
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and 0.86. Significant differences existed in access levels with
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transportation-based interventions significantly increasing coverage.
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The derived maps can help health policy planners identify underserved
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areas and monitor future reductions in inequalities. This work has
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theoretical implications for conceptualising healthcare accessibility
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besides advancing the literature on mixed methodologies.'
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affiliation: 'Ouko, JJO (Corresponding Author), Kenya Govt Med Res Ctr, Wellcome Trust
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Res Programme, Populat Hlth Unit, POB 43640-00100, Nairobi, Kenya.
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Ouko, Jacob Joseph Ochieng; Gachari, Moses Karoki; Sichangi, Arthur Wafula, Kenya
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Govt Med Res Ctr, Wellcome Trust Res Programme, Populat Hlth Unit, POB 43640-00100,
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Nairobi, Kenya.
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Alegana, Victor, Univ Southampton, Geog \& Environm Sci, Highfield Campus, Southampton
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SO17 1BJ, Hants, England.'
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author: Ouko, Jacob Joseph Ochieng and Gachari, Moses Karoki and Sichangi, Arthur
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Wafula and Alegana, Victor
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author-email: oukojacob1@gmail.com
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author_list:
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- family: Ouko
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given: Jacob Joseph Ochieng
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- family: Gachari
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given: Moses Karoki
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- family: Sichangi
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given: Arthur Wafula
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- family: Alegana
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given: Victor
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da: '2023-09-28'
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doi: 10.1111/1745-5871.12339
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eissn: 1745-5871
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files: []
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issn: 1745-5863
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journal: GEOGRAPHICAL RESEARCH
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keywords: 'maternal health; geographic information systems; travel times;
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healthcare access; multilevel modelling; Kenya'
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keywords-plus: SERVICES; ACCESS; CARE
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language: English
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month: AUG
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number: '3'
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number-of-cited-references: '30'
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orcid-numbers: 'Sichangi, Arthur/0000-0001-6266-8741
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Alegana, Victor/0000-0001-5177-9227'
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pages: 286-298
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papis_id: 6dbc3dd1662713556297b63d67a8456d
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ref: Ouko2019geographicinformatio
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researcherid-numbers: 'Sichangi, Arthur/Y-6599-2019
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Alegana, Victor/P-6579-2019'
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times-cited: '13'
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title: Geographic information system-based evaluation of spatial accessibility to
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maternal health facilities in Siaya County, Kenya
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000482408800007
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usage-count-last-180-days: '2'
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usage-count-since-2013: '10'
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volume: '57'
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web-of-science-categories: Geography
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year: '2019'
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