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Locational Distribution of Health Care Facilities in the Rural Area of Ondo State

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Locational Distribution of Health Care Facilities in the Rural Area of Ondo State British Journal of Education, Society & Behavioural Science 11(1): 1-8, 2015, Article no.BJESBS.17701 ISSN: 2278-0998 SCIENCEDOMAIN international www.sciencedomain.org Locational Distribution of Health Care Facilities in the Rural Area of Ondo State Jimoh Usman Umar1* and Wahab Bolanle1 1Department of Urban and Regional planning, Faculty of the Social Sciences, University of Ibadan, Nigeria. Authors’ contributions This work was carried out in collaboration between both authors. Author JUU designed the study wrote the protocol but author WB supervised the work. Author JUU performed the statistical analysis. Author JUU managed the analyses of the study. Author JUU wrote the first draft of the manuscript. Author JUU managed the literature searches while author WB edited the manuscript. Both authors read and approved the final manuscript. Article Information DOI: 10.9734/BJESBS/2015/17701 Editor(s): (1) Manouchehr (Mitch) Mokhtari, School of Public Health, University of Maryland, College Park, USA. Reviewers: (1) Ibiwani Alisa Hussain, Asia Pacific University of Technology and Innovation, Kuala Lumpur, Malaysia. (2) Timothy Golfa, Department of Medical, Surgical Nursing, College of Nursing and Midwifery, Nigeria. (3) Takashi Nakamura, Centre for Community Medicine, Jichi Medical University, Japan. Complete Peer review History: http://sciencedomain.org/review-history/10198 Received 24th March 2015 th Original Research Article Accepted 19 May 2015 Published 16th July 2015 ABSTRACT Aim: This research is aimed to assess the locational Distribution of health care facilities in the rural area of Ondo state. Study Design: Case study research design. Place and Duration of Study: Three senatorial districts of Ondo state Nigeria and lies within latitude 50 451 and 70521 N and longitude 40 201 and 60 51 E between July 2010 and September 2011. Methodology: This study was conducted within 3 senatorial districts in the study area. The Global Positioning System (GPS) was adopted to take the coordinate of all the existing health care facilities in the area. “Nearest Neighbour Analysis” (NNA) was the inferential statistical used in analyzing the data. This was used in establishing the distribution pattern of health facilities in the study area. Nearest Neighbour Analysis is the method of exploring pattern in the locational data by comparing _____________________________________________________________________________________________________ *Corresponding author: E-mail: [email protected]; Umar and Bolanle; BJESBS, 11(1): 1-8, 2015; Article no.BJESBS.17701 mean distance (Do) of the phenomena in question to the same expected mean distance (De) usually under a random distribution of any phenomenon. Results: The distribution of health care facilities in the area was clustered with the z-score table value for the three senatorial districts (Akure North, Ilaje and Ose) as 18.74, 35.31 and 21.44 respectively. This result does not enjoy adequate randomization thereby having implication for effective planning. Conclusion: Results from the study show that health care facilities in the state were unevenly distributed, hence hampering health development at the grassroots. In the area where population is not evenly distributed, the mean centre of population distribution is calculated as the “demand”, which forms the origin of location. The facility location point is considered as destination points or “supply”. The study suggests proper planning through the location of more and adequately equipped medical facilities in the rural area of Ondo state so as to enhance sustainable health care delivery. Keywords: Health care facilities; nearest neighbor analysis; rural area; Ondo state. 1. INTRODUCTION /STATEMENT OF emergence of many regions within the state PROBLEMS where both public and private health care facilities are sparsely provided. Often regions Good health is a precondition for socio-political with difficult terrain and unplanned and and economic development of any nation. In hazardous physical environment are neglected. recognition of this, the fourth National One major area in Nigeria which has generated Development plan [1] documented that good much interest nationally and internationally is health has a direct relationship with happiness, Ondo state, which is a petroleum-producing part intelligence, political stability and productivity of of the Niger delta. While successive the citizens of a country [2]. This is predicated on governments have invested in the health sector, accessibility to health care facilities identified to the result on health care access is not be one of the major indicators of development commensurable to its input as mortality is still and, according to [3], a strong influence of very high. This owes largely to the unequal individual’s earning capacity. However, the distribution of health care facilities within the area locational pattern of any facility, (Medical facilities particularly in the rural area that accommodates inclusive) can determine the level of its utility. a higher percentage of population [5]. Most From the locational pattern, the spatial researches conducted have for instance, web- distribution of any facility could be determined. based spatial approach to the distribution of [4] Sees spatial structure of a distribution as both health care facilities and the distribution of the location of each element relative to each Information System [6], patronage of health care other. Since the need for health care varies in facility [7] among others, without recourse to the space and organization, the physical locational distribution of health care facilities. environment also varies in characteristics from This is the gap the study intends to fill. This study place to place and this invariably has implications therefore focused on the locational distribution of for the pattern of demand for health care health care facilities in the rural area of Ondo facilities. The closer a health facility is to the state. people, the greater its utility and benefits. This can be connected to how they are distributed 1.1 Study Area over the space in both urban and rural areas. Ondo State of Nigeria was one of the seven Consequent upon this, the supply of quality states created on the 3rd February, 1976 by the healthcare services in isolated rural areas is a Federal Military Government of Nigeria. (Fig. 1) It challenge in many settings. The quantitative and was carved out of the old Western State. The qualitative shortages plus unequal distribution of state covers a total area of the former Ondo health workers at the expense of rural areas province, created in 1915 with Akure as the characterize sub Saharan countries including provincial headquarters. It lies between latitude Nigeria. In Ondo state for example, explicit 5° 45' and 7°52' N and longitude 4° 20' and 6° 5' consideration has not been given to the need for E. Its land area is about 15,500 Square equity in the planning and distribution of health kilometers. Edo and Delta States bound Ondo care facilities over the years. This has led to the State on the East, on the West by Ogun and 2 Umar and Bolanle; BJESBS, 11(1): 1-8, 2015; Article no.BJESBS.17701 Osun States, on the North by Ekiti and Kogi there were additional 30 comprehensive health States and to the South by the Bight of Benin centres, as against 2 in 1979. However, a result and the Atlantic Ocean (Fig. 1). of the location quotient analysis indicated increasing disparities in the distribution of both Until recently cocoa used to be the major source hospitals and lower level health facilities. of wealth for the state but this has been replaced Apparently, though relative to their population, by petroleum which is prospected in Ilaje and some LGAs have an excess share of the health Ese Odo local government areas. The population facilities while some have shortfall. of more than 55% in the rural areas of Ondo State lived below poverty level [8]. This condition 1.2 Literature Review of poverty was aggravated due to the poor attention given to the health sector in the state. Hospital functions such as food in – patient care or bed-related function. However what is called Going back to history, in 1979, when the civilian hospitals in most Nigerian cities fall short of all government took over, the number of health these. Hence health care facilities have been facilities was increased – hospitals rose from 18 categorized in this research into, small clinics, to 26 in number, maternity centres from 127 to health centers and major centers based on the 164, and dispensaries from 153 to 173. By 1985, facilities and services provided [9]. Fig. 1. Ondo State and selected local government areas of the study Source: Ministry of Lands and Survey, Ondo State, 2006 3 Umar and Bolanle; BJESBS, 11(1): 1-8, 2015; Article no.BJESBS.17701 'Closing the gap in indigenous health status' and [16], observed in his study of overview of 'improving distribution and equitable access to infrastructural distribution of healthcare services services' have been identified as national in Nigeria and discovered that the distribution of priorities [10]. Improving access to acceptable, medical care delivery in Nigeria has favoured the adequately resourced, sustainable models of urban population at the expense of the rural Also, PHC in rural and particularly remote areas, in terms of infrastructural distribution of where health outcomes are worse and there is a healthcare, the rural areas (mainly the majority) high proportion of indigenous residents,
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