Environmental Technology & Science Journal Vol. 9 Issue 1 June 2018 Assessment of Spatial Distribution and Range of Service of Public Health Facilities in Jos South Local Government Area of Plateau State, Nigeria 1Samuel Adebayo OJO, 2Gideon Sunday OWOYELE, 2Owoeye Olusegun IDOWU 1National Centre for Remote Sensing (NCRS), Jos, Plateau State, Nigeria 2Department of Urban and Regional Planning, Federal University of Technology, Minna, Nigeria. [email protected] The spatial disparity in the distribution of health facilities is a considerable problem in the health care delivery system remarkably in developing countries like Nigeria. This study assessed the spatial distribution and range of service of public health facilities in Jos South Local Government Area of Plateau State. Both primary and secondary data were used in this study. The inventory of all the public health facilities in the area was taken and location of the facilities was geo-coded using handheld Global Positioning System (GPS). Average nearest neighbour analysis was employed to assess the spatial pattern and distribution of the facilities. Network and buffering analyses were employed to analyse the range of service. The study revealed forty public health facilities: one (1) secondary and thirty-nine (39) primary health facilities distributed across the study area. The study concluded that health facilities in Jos South Local Government were spatially dispersed, the pattern which is tending to be more pronounced in the southern part than in the northern part. It, therefore, recommended the development of a strategy plan, which is to integrate non-government stakeholders in the planning of health service delivery. Keywords: buffering, distribution, GIS, public health, spatial range of service, Introduction plans in relation to the personal and Human health is a key factor in the population-based health care goals within sustainable development agenda and goal. their societies, so the welfare of the public Irrespective of the developmental and through the provision of health facilities is technological status of the society; health one of the key policies and responsibility of care system is crucial to the welfare of the government, particularly in Nigeria (Scott- society (World Health Organisation Emuakpor, 2010). (WHO), 2010; Bhatt & Joshi, 2013; Owoyele et al., 2015a). Health care systems In Nigeria, health care delivery service is are organisations established to meet the provided by a dual system comprising health needs of target populations; its exact stakeholders from the public and private configuration varies among nations. The sectors including the private for-profit as need for health varies in space as the well as the private not-for-profit physical environment varies in organisations (Nnamuchi & Metiboba, characteristics from place to place and this 2015). The public health care system is the invariably has implications for the pattern of largest and central to Nigeria’s health care demand for health care (Onokerhoraye, delivery operating along the lines of 1999; WHO, 1998). Countries and primary, secondary and tertiary health care jurisdictions have different policies and systems at the local government, state and federal levels respectively (National 85 Assessment of Spatial Distribution and Range of Service of Public Health Facilities in Jos South Local Government Area of Plateau State, Nigeria Ojo, Owoyele & Idowu Primary Health Care Development Agency the proximity and radius of service of the (NPHCDA), 2013; Umukoro, 2012). The health facilities (Mansour, 2016; Dobrica et public health institutions including primary al., 2010; Yerramilli & Fonseca, 2014; healthcare comprising health centres, clinics Ejiagha et al., 2012). This technology and health posts; hospitals (secondary integrates the statistical and geographic data healthcare); and tertiary healthcare are and allow the visualisation of such spatial prominent for maintaining population health relationships, hence the underlying cause of since their services are relatively the distribution can be determined (Hazrin inexpensive (NPHCDA, 2013). The et al., 2013; Dobrica et al., 2010). distribution of the public health facilities was addressed in a policy contained in This study is targeted to examine the Nigeria’s Fourth National Development distribution patterns and range of service of Plan (NFNDP) (1981 - 1985) framework public health facilities in Jos South Local (Scott-Emuakpor, 2010) and adopted by the Government Area (LGA) of Plateau State, relevant health agencies including National Nigeria with the view to understand the Primary Health Care Development Agency locational distribution using Geographic (NPHCDA). Information System (GIS). However, the chaotic and lopsided spatial Study Area distribution of these public health care The study area is Jos South Local facilities which is perceived as unfair and Government Area (LGA) of Plateau State, socially biased has drawn a considerable Nigeria. The area, located between latitude attention of the medical geographical 9°48′00″N and longitude 8°52′00″E in researchers and urban planners mostly in North Central Geo-Political Zone of developing countries like Nigeria to Nigeria, covers about 510 km2 with consider various measures to assess the approximately 1,250 metres above sea level spatial distribution impact on the use of and bounded by the Jos North LGA in the healthcare system (Scott-Emuakpor, 2010; northern part, and Jos East LGA in the Jimoh & Azubike, 2012; Owoyele et al., eastern part, Bassa in the north-western side, 2015b). Riyom and Barkin Ladi in the southern part Analysing the spatial distribution of health (Figure 1). facilities provides important information on the location of such health facilities and The indigenous ethnic group of the area is evaluating the range of health service is one Berom, other ethnic groups commonly of the most important measures to assess the found in the area are Jarawa, Hausa, Fulani, accessibility of the target population to the Ibo, Tiv, Idoma and Yoruba. The population health facility (Rob, 2003; Mansour, 2016). of Jos South LGA was 306,716 persons with Many medical geographical researchers and the population density of 503 persons per urban planners have appreciably utilised square kilometre at the 2006 Nigerian geographic information system (GIS) to national population census (NPC, 2006). adequately provide information on the The total population as projected based on spatial patterns, accessibility and the range the Nigerian annual growth rate of 2.7 % of service of the health facilities. Using (World Bank, 2016) is estimated as average nearest neighbour analysis, 412,200. This population appears to be comparing the spatial distribution of health much denser towards the northern region as facilities and hypothetically-based random a result of a concentration of more spatial distribution to identify and quantify settlements due to the influence of political spatial distribution patterns of the facilities headquarters, commercial and mining provide good approach (Hazrin et al., 2013; activities taking place in the region. Owoyele et al., 2015b; Mansour, 2016). Also, network analysis can be used to The local government is sub-divided into evaluate the shortest accessible routes to the twenty political wards namely Bukuru, facilities and buffering in order to analyse Chugwi, Dashonong, Du ‘A’, Du ‘B’, 86 Environmental Technology & Science Journal Vol. 9 Issue 1 June 2018 Giring, Gyel ‘A’, Gyel ‘B’, Hwolshe, Kuru Nigeria as the spatial zoning boundary ‘A’, Kuru ‘B’, Kushe, Shen, Sot, Tanchol, (Figure 2). Turu ‘A’, Turu ‘B’, Vwang, Zawang ‘A’ and Zawang ‘B’. The headquarters is located at Bukuru. The study used political ward being the smallest political structure in (b) Figure 1: Map of Plateau State in context of Nigeria. Figure 2: Map of Jos South LGA, Showing wards and Settlements 87 Assessment of Spatial Distribution and Range of Service of Public Health Facilities in Jos South Local Government Area of Plateau State, Nigeria Ojo, Owoyele & Idowu Materials and Methods dispersed (Environmental Systems Data Collection Research Institute (ESRI), 2016; Hazrin et Data on public health facilities was obtained al., 2013). from Jos South LGA headquarters and the Plateau State Ministry of Health and In order to effectively and efficiently incorporated in GIS environment. All analyse the physical accessibility and health available public health facilities in the area service coverage, a variable-radius measure were identified and their location was geo- was used in this study in line with NFNDP coded using handheld GPS (Garmin) (1981-1985) recommendations for different through in situ data collection method. categories of health facilities ranging from Population information was obtained from hospitals, health centres, clinics to health the National Population Commission (NPC) posts/dispensaries. The variable-radius based on 1991 national population census. measure defines a healthcare service radius A base map containing ward boundaries, based on the facility’s characteristics and rivers, railway and road networks were characteristics of the local population as acquired from the Plateau State Ministry of well as the land area. Radii of 15, 3, 2 and 1 Land and Survey and SPOT 5 satellite km were adopted for Hospital (secondary imagery of Jos south LGA was provided by health facility), health centres, clinics and the National Centre for Remote Sensing health posts respectively. Buffering