ArticleBMJ global health2021
Optimising geographical accessibility to primary health care: a geospatial analysis of community health posts and community health workers in Niger.
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 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers to utilization of primary healthcare services: a systematic review of experiences in ten selected countries.International journal of public health · 2026Pooled it
- Distance to Health Centers and Effectiveness of Azithromycin Mass Administration for Children in Niger: A Secondary Analysis of the MORDOR Cluster Randomized Trial.JAMA network open · 2023Trial
- Essential medicines out of reach: a cross-sectional study of community-level access in Eastern Uganda.BMC health services research · 2026Article
- Care pathways for critically ill children aged 0-5 years arriving at district hospitals in Burkina Faso, Guinea, Mali, and Niger (2022): a cross-sectional study.BMC public health · 2025Article
- Socioeconomic Risk Factors Associated With Acute Malnutrition Severity Among Under-Five Children Based on a Machine Learning Approach: The Case of Rural Emergency Contexts in Niger and Mali.Maternal & child nutrition · 2025Article
- Enhancing patient accessibility of primary care: the redesign of Italian territorial medicine.Health care management science · 2025Article
- Article
- Observing Healthcare Leaders in Action After a Pathways to Leadership for Health Transformation Programme by World Health Organization Regional Office for Africa in Benin and Niger.Journal of healthcare leadership · 2025Article
- Combining OpenStreetMap mapping and route optimization algorithms to inform the delivery of community health interventions at the last mile.PLOS digital health · 2024Article
- Enablers and barriers of community health programs for improved equity and universal coverage of primary health care services: A scoping review.BMC primary care · 2024Article
- Optimization of the emergency obstetric and neonatal care network in Benin through expert-based sub-national prioritizations.Frontiers in global women's health · 2024Article
- Effects of spatial accessibility of community health services on the activities of daily living among older adults in China: a propensity score matching study.Frontiers in public health · 2024Article
- Successes, weaknesses, and recommendations to strengthen primary health care: a scoping review.Archives of public health = Archives belges de sante publique · 2023Article
- Effectiveness and Coverage of Severe Acute Malnutrition Treatment with a Simplified Protocol in a Humanitarian Context in Diffa, Niger.Nutrients · 2023Article
- Effectiveness of community case management of malaria on severe malaria and inpatient malaria deaths in Zambia: a dose-response study using routine health information system data.Malaria journal · 2023Observational
- Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger.Frontiers in nutrition · 2023Article
- Spatial Accessibility Analysis of Medical Facilities Based on Public Transportation Networks.International journal of environmental research and public health · 2022Article
- Scaling severe acute malnutrition treatment with community health workers: a geospatial coverage analysis in rural Mali.Human resources for health · 2022Article
- Optimising scale and deployment of community health workers in Sierra Leone: a geospatial analysis.BMJ global health · 2022Article
- Use of Physical Accessibility Modelling in Diagnostic Network Optimization: A Review.Diagnostics (Basel, Switzerland) · 2022Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about the contribution of community health posts and community health workers (CHWs) to geographical accessibility of primary healthcare (PHC) services at community level and strategies for optimising geographical accessibility to these services.
methodsUsing a complete georeferenced census of community health posts and CHWs in Niger and other high-resolution spatial datasets, we modelled travel times to community health posts and CHWs between 2000 and 2013, accounting for training, commodities and maximum population capacity. We estimated additional CHWs needed to optimise geographical accessibility of the population beyond the reach of the existing community health post network. We assessed the efficiency of geographical targeting of the existing community health post network compared with networks designed to optimise geographical targeting of the estimated population, under-5 deaths and
resultsThe per cent of the population within 60-minute walking to the nearest community health post with a CHW increased from 0.0% to 17.5% between 2000 and 2013. An estimated 10.4 million people (58.5%) remained beyond a 60-minute catchment of community health posts. Optimal deployment of 7741 additional CHWs could increase geographical coverage from 41.5% to 82.9%. Geographical targeting of the existing community health post network was inefficient but optimised networks could improve efficiency by 32.3%-47.1%, depending on targeting metric. INTERPRETATIONS: We provide the first estimates of geographical accessibility to community health posts and CHWs at national scale in Niger, highlighting improvements between 2000 and 2013, geographies where gaps remained and approaches for optimising geographical accessibility to PHC services at community level.
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