Improving the Distribution of Rural Health Houses Using Elicitation and GIS in Khuzestan Province (the Southwest of Iran)

Document Type : Original Article

Authors

1 Department of Health Information Technology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Social Determinants of Health Research Center, Department of Health Information Technology, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran

3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran

4 Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran

5 Department of Health Information Technology, Paramedical School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

6 Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran

Abstract

Background
Rural health houses constitute a major provider of some primary health services in the villages of Iran. Given the challenges of providing health services in rural areas, health houses should be established based on the criteria of health network systems (HNSs). The value of these criteria and their precedence over others have not yet been thoroughly investigated. The present study was conducted to propose a model for improving the distribution of rural health houses in HNSs.
 
Methods
The present applied study was conducted in Khuzestan province in the southwest of Iran in 2014-2016. First, the descriptive and spatial data required were collected and entered into ArcGIS after modifications, and the Geodatabase was then created. Based on the criteria of the HNS and according to experts’ opinions, the main criteria and the sub-criteria for an optimal site selection were determined. To determine the criteria’s coefficient of importance (ie, their weight), the main criteria and the sub-criteria were compared in pairs according to experts’ opinions. The results of the pairwise comparisons were entered into Expert Choice and the weight of the main criteria and the sub-criteria were determined using the analytic hierarchy process (AHP). The application layers were then formed in geographic information system (GIS). A model was ultimately proposed in the GIS for the optimal distribution of rural health houses by overlaying the weighting layers and the other layers related to villages and rural health houses.
 
Results
Based on the experts’ opinions, six criteria were determined as the main criteria for an optimal site selection for rural health houses, including welfare infrastructures, population, dispersion, accessibility, corresponding routes, distance to the rural health center and the absence of natural barriers to accessibility. Of the main criteria proposed, the highest weight was given to “population” (0.506). The priorities suggested in the proposed model for establishing rural health houses are presented within five zoning levels –from excellent to very poor.
 
Conclusion
The results of the study showed that the proposed model can help provide a better picture of the distribution of rural health houses. The GIS is recommended to be used as a means of making the HNS more efficient.

Keywords

Main Subjects

References

  1. Tavassoli M. Iranian health houses open the door to primary care: working in pairs out of modest, village-based facilities, the islamic republic of Iran’s trained community health workers, the behvarzan, provide basic health care to most of the country’s rural population. Bull World Health Organ. 2008;86(8):585.
  2. Lokhman MT, Rasam A, Rauf A, Noor AMM. Reforming health care facility using geographical information system. Paper presented at: Control and System Graduate Research Colloquium (ICSGRC), 2012 IEEE; July 16-17, 2012; Shah Alam, Selangor, Malaysia.
  3. Strasser R. Rural health around the world: challenges and solutions. Fam Pract. 2003;20(4):457-463.
  4. Thomas TL, DiClemente R, Snell S. Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities. Health Educ J. 2014;73(3):285-294.  doi:10.1177/0017896912471049
  5. Patil AV, Somasundaram K, Goyal R. Current health scenario in rural India. Aust J Rural Health. 2002;10(2):129-135.
  6. Mujeri MK. Bangladesh: Bringing poverty focus in rural infrastructure development. Issues in Employment and Poverty– Working paper No. 6. http://www.ilo.org/employment/Whatwedo/Publications/WCMS_120739/lang--en/index.htm.  Published 2006.
  7. Taylor M. ‘Freedom from poverty is not for free’: rural development and the microfinance crisis in Andhra Pradesh, India. Journal of Agrarian Change. 2011;11(4):484-504.
  8. Mwabu G, Thorbecke E. Rural development, growth and poverty in Africa. J Afr Econ. 2004;13(suppl 1):i16-i65.
  9. Regan S, Wong S. Patient perspectives on primary health care in rural communities: effects of geography on access, continuity and efficiency. Rural Remote Health. 2009;9(1):1142.
  10. Mehryar AH, Aghajanian A, Ahmad-Nia S, Mirzae M, Naghavi M. Health Indicators, and Rural Poverty Reduction: The experience of Iran. The xxv General Population Conference of the International Union for the Scientific Study of Population (IUSSP); Tours, France; 2005.
  11. Aghajanian A, Mehryar AH, Ahmadnia S, Kazemipour S. Impact of rural health development programme in the Islamic Republic of Iran on rural-urban disparities in health indicators. East Mediterr Health J. 2007;13(16):1466-1475.
  12. General Principles in structures of the County healthcare network development plan. Promotion & network development center. Tehran: Ministry of Health and Medical Education; 2007.
  13. Salehi-Isfahani D, Abbasi-Shavazi MJ, Hosseini-Chavoshi M. Family planning and fertility decline in rural Iran: the impact of rural health clinics. Health Econ. 2010;19(S1):159-180. doi:10.1016/j.seps.2008.02.012
  14. Pilehroodi S. County Healthcare Network. 3rd ed. Tehran: Ministry of Health and Medical education Press; 2006.
  15. Pakshir HR. Oral health in Iran. Int Den J. 2004;54(S6):367-372.
  16. Abbasi-Shavazi MJ, McDonald P, Hosseini-Chavoshi M. The fertility transition in Iran. In: Revolution and Reproduction. Dordrecht: Springer;2009.
  17. Erfani A, McQuillan K. Rapid fertility decline in Iran: analysis of intermediate variables. J Biosoc Sci. 2008;40(03):459-478. doi:10.1017/S002193200700243X
  18. Sabesan S, Raju K. GIS for rural health and sustainable development in India, with special reference to vector-borne diseases. Curr Sci. 2005;88(11):1749.
  19. Cromley EK, McLafferty SL. GIS and Public Health. Guilford Press; 2011.
  20. Farry P, Thompson R, Robertson H, Benwell G, Williamson M. The role of GIS in supporting evidence-based rural health service planning and evaluation: a New Zealand case study. NZFP. 2008;13:6.
  21. Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci. 2008;1(1):83-98.
  22. 22.   Chandio IA, Matori ANB, WanYusof KB, Talpur MAH, Balogun A-L, Lawal DU. GIS-based analytic hierarchy process as a multicriteria decision analysis instrument: a review. Arabian Journal of Geosciences. 2013;6(8):3059-3066. doi:10.1007/s12517-012-0568-8
  23. Khuzestan Province. Wikipedia website. https://en.wikipedia.org/wiki/Khuzestan_Province#Agriculture.   Accessed May 16, 2015.
  24. Tahmasbi M, Rezaei-Moghaddam K. Unsustainability of rural ecotourism in Khuzestan province. J Hum Environ. 2010;8(4):3-15.
  25. Shahabfar A, Eitzinger J. Agricultural drought monitoring in semi-arid and arid areas using MODIS data. J Agric Sci. 2011;149(4):403-414.
  26. Coyle G. The analytic hierarchy process (AHP) introduction. In: Practical Strategy. Open Access Material. Pearson Education Limited; 2004.
  27. Mekaniki J, Sadeghi H. Determining the optimal spatial pattern of rural service centers by AHP method with an approach to land suitability (Case study: Dehdiz District, Izeh County). Journal of Research and Rural Planning. 2012;1:9-12.
  28. Kofie RY, Møller-Jensen L. Towards a framework for delineating sub-districts for primary health care administration in rural Ghana: a case study using GIS. Norsk Geografisk Tidsskrift. 2001;55(1):26-33.
  29. Safdari R, Ghazisaeedi M, Sheikhtaheri A, Saremian M. Prioritizing the factors influencing places of rural health centers equipped with telehealth services using Analytical Hierarchy Process. Journal of Clinical Research Paramedical Sciences. 2015;4(1):24-33.
  30. Mwasi BN. Factors affecting access to rural health services: A Case Study of Baringo Area of Kenya Using GIS. African Books Collective; 2010.

Files

History

  • Receive Date: 13 February 2017
  • Revise Date: 14 July 2017
  • Accept Date: 09 August 2017
  • First Publish Date: 01 April 2018

Share

How to cite

Statistics