ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 14
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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A modern approach to assess healthcare equity:
Observations from a primary care spatial accessibility study
in rural Sri Lanka
Dr Parami Abeyrathna1, Manjula Weerasinghe1, Suneth Agampodi1, A/Prof Shyamalee
Samaranayake2, Dr Janaka Pushpakumara1
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Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, 2Faculty of Medical
Sciences, University of Sri Jayawardhanapura
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Introduction
Ensuring healthcare equity is an essential component of universal health coverage (UHC) to overcome
the disparities in healthcare access for underprivileged populations.
Objective
To assess the spatial accessibility of primary care facilities (PCF) in the Anuradhapura District (AD),
Sri Lanka.
Methods
A cross-sectional spatial analytical study was conducted in AD referring to the spatial maps
(Department of Survey) and census data (Department of Census and Statistics) of 657 Grama
Niladhari Divisions (GND); 403 geospatial locations of western (allopathic) and Ayurveda PCFs and 523
primary care doctors (PCD). The ESRI-ARC Geographic Information System was used to analyse the
Spatial Accessibility Index (SAI; the sum of, the ratio of the PCD to a catchment population of each
PCF located in spatial distances of 5 km [5SpD] and 10 km [10SpD] from a GND).
Results
Mean SAIs of 4.50×10 –4 and 4.67×10 –4 were reported for any PCD located in 5SpD and 10SpD from a
GND. A significant difference in SAIs was reported between urban and rural populations. The minimum
national primary care coverage (NPCC) target of 1 PCD per 5000 population was achieved in 70% and
92% of GNDs in 5SpD and 10SpD, respectively. Closeness to main roads and the main city and less
poverty were associated with a higher SAI. The elderly and Sinhalese populations were dominant in
areas with higher SAI.
Conclusion
Primary care accessibility was affected by the distance to the cities and main roads, the age and
ethnic structure of the population and poverty. NPCC targets are yet to be achieved for the most
deserving in rural Sri Lanka. Modern approaches should be applied in assessing UHC for proper
estimation and resolution of disparities.
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