Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Tuberculosis | Research article

Geographic accessibility to public health facilities providing tuberculosis testing services at point-of-care in the upper east region, Ghana

Authors: Desmond Kuupiel, Kwame M. Adu, Felix Apiribu, Vitalis Bawontuo, Duncan A. Adogboba, Kwasi T. Ali, Tivani P. Mashamba-Thompson

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

In Ghana, limited evidence exists about the geographical accessibility to health facilities providing tuberculosis (TB) diagnostic services to facilitate early diagnosis and treatment. Therefore, we aimed to assess the geographic accessibility to public health facilities providing TB testing services at point-of-care (POC) in the Upper East Region (UER), Ghana.

Methods

We assembled detailed spatial data on all 10 health facilities providing TB testing services at POC, and landscape features influencing journeys. These data were used in a geospatial model to estimate actual distance and travel time from the residential areas of the population to health facilities providing TB testing services. Maps displaying the distance values were produced using ArcGIS Desktop v10.4. Spatial distribution of the health facilities was done using spatial autocorrelation (Global Moran’s Index) run in ArcMap 10.4.1. We also applied remote sensing through satellite imagery analysis to map out residential areas and identified locations for targeted improvement in the UER.

Results

Of the 13 districts in the UER, 4 (31%) did not have any health facility providing TB testing services. In all, 10 public health facilities providing TB testing services at POC were available in the region representing an estimated population to health facility ratio of 125,000 people per facility. Majority (60%) of the health facilities providing TB testing services in the region were in districts with a total population greater than 100,000 people. Majority (62%) of the population resident in the region were located more than 10 km away from a health facility providing TB testing services. The mean distance ± standard deviation to the nearest public health facility providing TB testing services in UER was 33.2 km ± 13.5. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest facility providing TB testing services in the UER was 99.6 min ± 41.6. The results of the satellite imagery analysis show that 51 additional health facilities providing TB testing services at POC are required to improve geographical accessibility. The results of the spatial autocorrelation analysis show that the spatial distribution of the health facilities was dispersed (z-score = − 2.3; p = 0.02).

Conclusion

There is poor geographic accessibility to public health facilities providing TB testing services at POC in the UER of Ghana. Targeted improvement of rural PHC clinics in the UER to enable them provide TB testing services at POC is highly recommended.
Appendix
Available only for authorised users
Literature
2.
go back to reference Gupta-Wright A, Corbett EL, van Oosterhout JJ, Wilson D, Grint D, Alufandika-Moyo M, et al. Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial. Lancet. 2018;392(10144):292–301.CrossRef Gupta-Wright A, Corbett EL, van Oosterhout JJ, Wilson D, Grint D, Alufandika-Moyo M, et al. Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial. Lancet. 2018;392(10144):292–301.CrossRef
3.
go back to reference Dodd PJ, Yuen CM, Becerra MC, Revill P, Jenkins HE, Seddon JA. Potential effect of household contact management on childhood tuberculosis: a mathematical modelling study. Lancet Glob Health. 2018;6:e1329–e1338.CrossRef Dodd PJ, Yuen CM, Becerra MC, Revill P, Jenkins HE, Seddon JA. Potential effect of household contact management on childhood tuberculosis: a mathematical modelling study. Lancet Glob Health. 2018;6:e1329–e1338.CrossRef
4.
go back to reference Bjerrum S, Kenu E, Lartey M, Newman MJ, Addo KK, Andersen AB, et al. Diagnostic accuracy of the rapid urine lipoarabinomannan test for pulmonary tuberculosis among HIV-infected adults in Ghana–findings from the DETECT HIV-TB study. BMC Infect Dis. 2015;15(1):407.CrossRef Bjerrum S, Kenu E, Lartey M, Newman MJ, Addo KK, Andersen AB, et al. Diagnostic accuracy of the rapid urine lipoarabinomannan test for pulmonary tuberculosis among HIV-infected adults in Ghana–findings from the DETECT HIV-TB study. BMC Infect Dis. 2015;15(1):407.CrossRef
6.
go back to reference World Health Organization. Global tuberculosis report 2016. 2016. World Health Organization. Global tuberculosis report 2016. 2016.
7.
go back to reference Asandem DA, Asante-Poku A, Asare P, Aboagye SY, Stephen OW, Danso E, et al. OMNIgene SPUTUM: a good transport and decontaminating reagent for tuberculosis testing. Int J Mycobacteriol. 2018;7(3):222–7.CrossRef Asandem DA, Asante-Poku A, Asare P, Aboagye SY, Stephen OW, Danso E, et al. OMNIgene SPUTUM: a good transport and decontaminating reagent for tuberculosis testing. Int J Mycobacteriol. 2018;7(3):222–7.CrossRef
8.
go back to reference Kuupiel D, Tlou B, Bawontuo V, Mashamba-Thompson TP. Accessibility of pregnancy-related point-of-care diagnostic tests for maternal healthcare in rural primary healthcare facilities in northern Ghana: a cross-sectional survey. Heliyon. 2019;5(2):e01236.CrossRef Kuupiel D, Tlou B, Bawontuo V, Mashamba-Thompson TP. Accessibility of pregnancy-related point-of-care diagnostic tests for maternal healthcare in rural primary healthcare facilities in northern Ghana: a cross-sectional survey. Heliyon. 2019;5(2):e01236.CrossRef
11.
go back to reference Dobson JE, Bright EA, Coleman PR, Durfee RC, Worley BA. LandScan: a global population database for estimating populations at risk. Photogramm Eng Remote Sens. 2000;66(7):849–57. Dobson JE, Bright EA, Coleman PR, Durfee RC, Worley BA. LandScan: a global population database for estimating populations at risk. Photogramm Eng Remote Sens. 2000;66(7):849–57.
12.
go back to reference Becher H, Muller O, Jahn A, Gbangou A, Kynast-Wolf G, Kouyate B. Risk factors of infant and child mortality in rural Burkina Faso. Bull World Health Organ. 2004;82(4):265–73.PubMedPubMedCentral Becher H, Muller O, Jahn A, Gbangou A, Kynast-Wolf G, Kouyate B. Risk factors of infant and child mortality in rural Burkina Faso. Bull World Health Organ. 2004;82(4):265–73.PubMedPubMedCentral
14.
go back to reference Gething PW, Johnson FA, Frempong-Ainguah F, Nyarko P, Baschieri A, Aboagye P, et al. Geographical access to care at birth in Ghana: a barrier to safe motherhood. BMC Public Health. 2012;12(1):991.CrossRef Gething PW, Johnson FA, Frempong-Ainguah F, Nyarko P, Baschieri A, Aboagye P, et al. Geographical access to care at birth in Ghana: a barrier to safe motherhood. BMC Public Health. 2012;12(1):991.CrossRef
15.
go back to reference Dangisso MH, Datiko DG, Lindtjorn B. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia. Glob Health Action. 2015;8:29443.CrossRef Dangisso MH, Datiko DG, Lindtjorn B. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia. Glob Health Action. 2015;8:29443.CrossRef
17.
go back to reference Wiggins S, Marfo K, Anchirinah V. Protecting the forest or the people? Environmental policies and livelihoods in the forest margins of southern Ghana. World Dev. 2004;32(11):1939–55.CrossRef Wiggins S, Marfo K, Anchirinah V. Protecting the forest or the people? Environmental policies and livelihoods in the forest margins of southern Ghana. World Dev. 2004;32(11):1939–55.CrossRef
18.
go back to reference MacKinney A, Coburn A, Lundblad J, McBride T, Mueller K, Watson S. Access to rural health care–a literature review and new synthesis. Policy report Rupri: rural policy research institute; 2014. MacKinney A, Coburn A, Lundblad J, McBride T, Mueller K, Watson S. Access to rural health care–a literature review and new synthesis. Policy report Rupri: rural policy research institute; 2014.
19.
go back to reference Finnie RK, Khoza LB, van den Borne B, Mabunda T, Abotchie P, Mullen PD. Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV. Tropical Med Int Health. 2011;16(4):394–411.CrossRef Finnie RK, Khoza LB, van den Borne B, Mabunda T, Abotchie P, Mullen PD. Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV. Tropical Med Int Health. 2011;16(4):394–411.CrossRef
20.
go back to reference Ross JM, Cattamanchi A, Miller CR, Tatem AJ, Katamba A, Haguma P, et al. Investigating barriers to tuberculosis evaluation in Uganda using geographic information systems. Am J Trop Med Hyg. 2015;93(4):733–8.CrossRef Ross JM, Cattamanchi A, Miller CR, Tatem AJ, Katamba A, Haguma P, et al. Investigating barriers to tuberculosis evaluation in Uganda using geographic information systems. Am J Trop Med Hyg. 2015;93(4):733–8.CrossRef
21.
go back to reference Langford M, Higgs G. Measuring potential access to primary healthcare services: the influence of alternative spatial representations of population. Prof Geogr. 2006;58(3):294–306.CrossRef Langford M, Higgs G. Measuring potential access to primary healthcare services: the influence of alternative spatial representations of population. Prof Geogr. 2006;58(3):294–306.CrossRef
22.
go back to reference Kuupiel D, Bawontuo V, Mashamba-Thompson TP. Improving the accessibility and efficiency of point-of-care diagnostics Services in low-and Middle-Income Countries: lean and agile supply chain management. Diagnostics. 2017;7(4):58.CrossRef Kuupiel D, Bawontuo V, Mashamba-Thompson TP. Improving the accessibility and efficiency of point-of-care diagnostics Services in low-and Middle-Income Countries: lean and agile supply chain management. Diagnostics. 2017;7(4):58.CrossRef
23.
go back to reference Bhaduri B, Bright E, Coleman P, Dobson J. LandScan. Geoinformatics. 2002;5(2):34–7. Bhaduri B, Bright E, Coleman P, Dobson J. LandScan. Geoinformatics. 2002;5(2):34–7.
24.
go back to reference World Health Organization. World Health Organization Model List of Essential In Vitro Diagnostics First edition (2018). Geneva: World Health Oraganization; 2018. p. 2018. World Health Organization. World Health Organization Model List of Essential In Vitro Diagnostics First edition (2018). Geneva: World Health Oraganization; 2018. p. 2018.
Metadata
Title
Geographic accessibility to public health facilities providing tuberculosis testing services at point-of-care in the upper east region, Ghana
Authors
Desmond Kuupiel
Kwame M. Adu
Felix Apiribu
Vitalis Bawontuo
Duncan A. Adogboba
Kwasi T. Ali
Tivani P. Mashamba-Thompson
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7052-2

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue