ArticleBMJ open2021
National optimisation of accessibility to emergency obstetrical and neonatal care in Togo: a geospatial analysis.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Artificial intelligence and the future of maternal and newborn health in low-income countries: advancing equity, early detection, and health system resilience.Frontiers in public health · 2026Review
- Mapping and quantifying travel time to define health facility catchment areas in Blantyre city in Malawi.Communications medicine · 2025Article
- Extreme geographic misalignment of healthcare resources and HIV treatment deserts in Malawi.Nature medicine · 2025Article
- Geospatial analysis and scale-up modelling of the impact of mobile programming on access to essential childhood vaccinations in Yemen.Communications medicine · 2025Article
- Article
- Improving complex health systems and lived environments for maternal and perinatal well-being in urban sub-Saharan Africa: the UrbanBirth Collective.Journal of global health · 2025Article
- Optimization of the emergency obstetric and neonatal care network in Benin through expert-based sub-national prioritizations.Frontiers in global women's health · 2024Article
- A geospatial analysis of accessibility and availability to implement the primary healthcare roadmap in Ethiopia.Communications medicine · 2023Article
- Article
- Use of Physical Accessibility Modelling in Diagnostic Network Optimization: A Review.Diagnostics (Basel, Switzerland) · 2022Review
- Travel scenario workshops for geographical accessibility modeling of health services: A transdisciplinary evaluation study.Frontiers in public health · 2022Article
- Differences between gridded population data impact measures of geographic access to healthcare in sub-Saharan Africa.Communications medicine · 2022Article
- Geographic barriers to establishing a successful hospital referral system in rural Madagascar.BMJ global health · 2021Article
- Population's Potential Accessibility to Specialized Palliative Care Services: A Comparative Study in Three European Countries.International journal of environmental research and public health · 2021Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesImproving access to emergency obstetrical and neonatal care (EmONC) is a key strategy for reducing maternal and neonatal mortality. Access is shaped by several factors, including service availability and geographical accessibility. In 2013, the Ministry of Health (MoH) of Togo used service availability and other criteria to designate particular facilities as EmONC facilities, facilitating efficient allocation of limited resources. In 2018, the MoH further revised and rationalised this health facility network by applying an innovative methodology using health facility characteristics and geographical accessibility modelling to optimise timely access to EmONC services. This study compares the geographical accessibility of the network established in 2013 and the smaller network developed in 2018.
designWe used data regarding travel modes and speeds, geographical barriers and topographical and urban constraints, to estimate travel times to the nearest EmONC facilities. We compared the EmONC network of 109 facilities established in 2013 with the one composed of 73 facilities established in 2018, using three travel scenarios (walking and motorised, motorcycle-taxi and walking-only).
resultsWhen walking and motorised travel is considered, the 2013 EmONC network covers 81% and 96.6% of the population at the 1-hour and 2-hour limit, respectively. These figures are slightly higher when motorcycle-taxis are considered (82.8% and 98%), and decreased to 34.7% and 52.3% for the walking-only scenario. The 2018 prioritised EmONC network covers 78.3% (1-hour) and 95.5% (2-hour) of the population for the walking and motorised scenario.
conclusionsBy factoring in geographical accessibility modelling to our iterative EmONC prioritisation process, the MoH was able to decrease the designated number of EmONC facilities in Togo by about 30%, while still ensuring that a high proportion of the population has timely access to these services. However, the physical access to EmONC for women unable to afford motorised transport remains inequitable.
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