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. 2022 Jan;55(1):49-59.
doi: 10.3961/jpmph.21.401. Epub 2021 Dec 28.

A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran

Zahra Mohammadi Daniali  1 , Mohammad Mehdi Sepehri  2 , Farzad Movahedi Sobhani  1 , Mohammad Heidarzadeh  3
Affiliations

A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran

Zahra Mohammadi Daniali et al. J Prev Med Public Health. 2022 Jan.

Abstract

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran.

Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties.

Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider.

Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

Keywords: Geographical location; Health equity; Healthcare facility; Maternal neonatal care; Public health; Regionalization.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest associated with the material presented in this paper.

Figures

Figure. 1.
Figure. 1.
Research methodology to find the optimal solution for maternal and neonatal care services. AHP, analytic hierarchy process; GIS, geographical information system; Min, minimum; Max, maximum.
Figure. 2.
Figure. 2.
Localized toolbox for finding the location-allocation of maternal and neonatal care services providers in ArcMap.
Figure. 3.
Figure. 3.
Location-allocation solution for level I (A), II (B), and III (C) maternal and neonatal care services.
Figure. 4.
Figure. 4.
Optimal allocation to satisfy the total demand for level III maternal and neonatal care services.
Figure. 5.
Figure. 5.
The location-allocation model for alternative level III maternal and neonatal care services.
None
See this image and copyright information in PMC

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References

    1. Rahbar M, Ahmadi M, Lornejad H, Habibelahi A, Sanaei-Shoar T, Mesdeaghinia A. Mortality causes in children 1-59 months in Iran. Iran J Public Health. 2013;42(Supple1):93–97. - PMC - PubMed
    1. World Health Organization Country profile: health system profile, Islamic Republic of Iran. 2006. [cited 2021 Jul 1]. Available from: http://www.emro.who.int/human-resources-observatory/countries/country-pr....
    1. Campbell OM, Graham WJ, Lancet Maternal Survival Series steering group Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368(9543):1284–1299. - PubMed
    1. Hare TS, Barcus HR. Geographical accessibility and Kentucky’s heart-related hospital services. Appl Geogr. 2007;27(3-4):181–205.
    1. Combier E, Charreire H, Le Vaillant M, Michaut F, Ferdynus C, Amat-Roze JM, et al. Perinatal health inequalities and accessibility of maternity services in a rural French region: closing maternity units in Burgundy. Health Place. 2013;24:225–233. - PubMed

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