ArticleBMJ global health2021
"In cities, it's not far, but it takes long": comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed.
- Article
- Multistakeholder perspectives on geographical accessibility to emergency obstetric care in Benin City, Nigeria.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Inter-facility travel time and referral for emergency obstetric care in the 15 most populated cities of Nigeria: a spatial analysis.BMC global and public health · 2026Article
- Levels of in-facility maternal mortality, obstetric complications and stillbirths in three urban referral hospitals in Guinea: analysis of routine data from May 2021 to April 2023.BMJ global health · 2026Article
- Geospatial analysis of COVID-19 vaccine access in Kenya: the interplay of travel time, perceived availability, and vaccine uptake.Journal of global health · 2026Article
- The richness of urban health realities lost in measurement monocultures.BMJ global health · 2026Article
- Strategies to improve outcomes of obstetric emergencies in sub-Saharan Africa: A scoping review.PloS one · 2026Article
- Variability in the Causes and Delay Factors Contributing to Maternal Mortality: Evidence From Maternal Death Surveillance Reports of 22 African Countries.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Article
- Beyond proximity: an observational study of stillbirth rates and emergency obstetric and newborn care accessibility in The Gambia.BMJ global health · 2025Observational
- Mixed vulnerabilities: the biological risk of high parity is aggravated by emergency referral in Benin, Malawi, Tanzania and Uganda.International journal for equity in health · 2025Article
- Care mobilities and associated contexts of hospital-based informal caregiving in Nigeria: Towards an explanatory framework.PloS one · 2025Article
- Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women's Self-Reported Care-Seeking Pathways.Global health, science and practice · 2024Article
- Trends and Inequalities in Maternal and Newborn Health Services for Unplanned Settlements of Lusaka City, Zambia.Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- Inequalities in geographical access to emergency obstetric and newborn care.Bulletin of the World Health Organization · 2024Article
- Urban and rural disparities in general hospital accessibility within a Chinese metropolis.Scientific reports · 2024Article
- Do current maternal health staffing and bed occupancy benchmarks work in practice? Results from a simulation model.BMJ public health · 2024Article
- Dynamic measurements of geographical accessibility considering traffic congestion using open data: a cross-sectional assessment for haemodialysis services in Cali, Colombia.Lancet regional health. Americas · 2024Article
- Socio-spatial equity analysis of relative wealth index and emergency obstetric care accessibility in urban Nigeria.Communications medicine · 2024Article
- Optimising availability and geographical accessibility to emergency obstetric care within a sub-national social health insurance scheme in Nigeria.Frontiers in health services · 2024Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTravel time to comprehensive emergency obstetric care (CEmOC) facilities in low-resource settings is commonly estimated using modelling approaches. Our objective was to derive and compare estimates of travel time to reach CEmOC in an African megacity using models and web-based platforms against actual replication of travel.
methodsWe extracted data from patient files of all 732 pregnant women who presented in emergency in the four publicly owned tertiary CEmOC facilities in Lagos, Nigeria, between August 2018 and August 2019. For a systematically selected subsample of 385, we estimated travel time from their homes to the facility using the cost-friction surface approach, Open Source Routing Machine (OSRM) and Google Maps, and compared them to travel time by two independent drivers replicating women's journeys. We estimated the percentage of women who reached the facilities within 60 and 120 min.
resultsThe median travel time for 385 women from the cost-friction surface approach, OSRM and Google Maps was 5, 11 and 40 min, respectively. The median actual drive time was 50-52 min. The mean errors were >45 min for the cost-friction surface approach and OSRM, and 14 min for Google Maps. The smallest differences between replicated and estimated travel times were seen for night-time journeys at weekends; largest errors were found for night-time journeys at weekdays and journeys above 120 min. Modelled estimates indicated that all participants were within 60 min of the destination CEmOC facility, yet journey replication showed that only 57% were, and 92% were within 120 min.
conclusionsExisting modelling methods underestimate actual travel time in low-resource megacities. Significant gaps in geographical access to life-saving health services like CEmOC must be urgently addressed, including in urban areas. Leveraging tools that generate 'closer-to-reality' estimates will be vital for service planning if universal health coverage targets are to be realised by 2030.
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