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Thesis Ebe 2019 Ma Kiese Ste Development of a Geographical Information System Based Transport Assessment Approach in Rural South Africa The Case of Healthcare Accessibility in Cape Winelands District Municipality Town Cape of University Dissertation presented in partial fulfilment of the requirement for the degree of Masters in Science, Civil Engineering Special field: Transport Studies, In the Department of Civil Engineering, EBE Faculty, University of Cape Town October 2019 By: Stephane Simon Masamba Ma-Kiese The copyright of this thesis vests inTown the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is to be used for private study or non- commercial research purposes Capeonly. of Published by the University of Cape Town (UCT) in terms of the non-exclusive license granted to UCT by the author. University Dedication This thesis is dedicated to the memory of my grandfather, Simon Masamba Makela. “Il est grand celui qui respecte le petit.” Development of a Geographical Information System Based Transport Assessment Approach in Rural South Africa The Case of Healthcare Accessibility in Cape Winelands District Municipality Dissertation presented in partial fulfilment of the requirement for the degree of Masters in Science, Civil Engineering Special field: Transport Studies Department of Civil Engineering, EBE Faculty, University of Cape Town Private Bag X3, Rondebosch, 7701 October 2019 By: Stephane Simon Masamba Ma-Kiese Declaration of Free License I Stephane Simon Masamba Ma-Kiese hereby: (a) grant the University free license to reproduce the above thesis in whole or in part, for the purpose of research; (b) declare that: (i) The research reported in this thesis, except otherwise indicated, is my original research. (ii) This thesis does not contain other persons’ data, pictures, graphs or other information, unless specifically acknowledge as being sourced from other persons. (iii) Neither the substance or any part of the thesis has been submitted in the past, or is being, or is to be submitted for a degree at the University of Cape Town or any other University. (iv) I am now presenting the thesis for examination for the Degree of Masters in Science. Signature: i ii Acknowledgments First and foremost, I would like to express my sincere gratitude to the almighty God, who enabled me to reach the completion of this thesis. My constant and daily prayers to him have come into realisation that I am grateful to mention today. My special thanks go to my supervisor, Associate Professor Marianne Vanderschuren, whose support and encouragement I am eternally grateful for. Thank you for all your support and guidance in these years of my Masters. Your valuable suggestions and comments always served as a source of inspiration and encouragement. I would like to thank you again for your hand of generosity when you spared no effort to offer me jobs as her research assistant on several occasions to cover my financial fall outs. I also extend a special token of appreciation to Associate Professor Mark Zuidgeest who showed me support and kindness that went beyond his responsibilities. Your advice and research resources provided clarity and direction. Many thanks go to my family for their constant encouragement, support and faith in me. My family was a constant source of reinsurance and always believed in me. The emotional support that you provided was a tower of strength on which I held tight. To my parents who paid for my tuition fees, this is for you, I am forever grateful. I would like to thank Thomas Slingsby and Nicholas Lindenberg in the UCT GIS Laboratory for all your help with ArcGIS computations. Last but not least, thank you to Cheryl Wright in the Department of Civil Engineering for your valuable time and constructive feedback on multiple draft versions. This thesis would not have been completed without your assistance. iii iv Plagiarism Declaration I know the meaning of plagiarism and declare that all the work in the document, save for that which is properly acknowledged, is my own. This thesis/dissertation has been submitted to the Turnitin module (or equivalent similarity and originality checking software) and I confirm that my supervisor has seen my report and any concerns revealed by such have been resolved with my supervisor. Student Number: MSMSTE003 Signature: v vi Abstract For communities in urban and rural areas, access to healthcare facilities is a very significant concern of service delivery to both public policy makers and urban planners. Many healthcare systems set one of their primary objectives to achieve equity and ease of access to healthcare facilities for the populations that they serve. Spatial distribution of population, transport infrastructure, as well as spatial distribution of healthcare facilities are key characteristics that influence the disparities in spatial accessibility to healthcare facilities. Regardless of the permanent interest in transport accessibility, it is often uncertain how different types of accessibility measures relate to one another and which conditions are best for applications. In general, the current study undertakes a statistical comparison among three spatial accessibility measures (representing the main categories of spatial accessibility models) to determine whether they are comparable and/or interchangeable. Specifically, this study aims to use a geographical information system based approach combined with spatial accessibility measures, in a case study, derived from fine spatial resolution datasets, to characterise and divulge spatial variations in individual’s access to healthcare facilities and identify deprived locations/local communities in a selected District Municipality of the Western Cape, South Africa. Results indicate that the main categories of spatial accessibility measures provide different interpretations of accessibility that cannot be reproduced by each other. However, the accessibility measures show a significant similar trend in variations of individual’s accessibility to healthcare services for the communities of Cape Winelands District Municipality. The study establishes that within the Cape Winelands there exist spatial variations in the distribution of accessibility to healthcare and characterises these variations. Key Words: Transport assessment, spatial accessibility, geographical information systems, rural access to health. vii viii Content Declaration of Free License .................................................................................................... i Acknowledgments ................................................................................................................ iii Plagiarism Declaration........................................................................................................... v Abstract ...............................................................................................................................vii Content .................................................................................................................................ix List of Figures ...................................................................................................................... xiii List of Tables ........................................................................................................................ xv List of Acronyms ................................................................................................................. xvii Chapter 1: Introduction ......................................................................................................... 1 1.1. Background to Study ............................................................................................... 1 1.2. Research Problem ................................................................................................... 4 1.3. Research Significance .............................................................................................. 5 1.4. Research Objectives ................................................................................................ 6 1.5. Research Questions................................................................................................. 7 1.6. Research Scope and Limitations .............................................................................. 7 1.7. Thesis Structure and Content .................................................................................. 9 Chapter 2: Review of Literature on Accessibility and Healthcare ......................................... 11 2.1 Definitions and Interpretations of Key Terms ............................................................ 11 2.1.1 Access ................................................................................................................. 11 2.1.2 Accessibility ........................................................................................................ 13 2.1.3 Spatial Accessibility ............................................................................................. 15 2.2 Component of Spatial Accessibility ............................................................................ 17 2.3 Indicators/Measures of Spatial Accessibility .............................................................. 18 2.4 Models for Spatial Accessibility Assessment .............................................................. 20 2.4.1 Cumulative Models ............................................................................................
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