ArticleHealth policy and planning2021
An assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeria.
Article in Health policy and planning, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- 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
- Urban-Rural Disparities in Geographic Healthcare Accessibility: A Comparative Study of Nigeria and Zambia.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- "Is she pregnant with Jesus?" exploring sociocultural obstacles to following medical advice in the context of stillbirth prevention in Nigeria.BMC pregnancy and childbirth · 2025Article
- Beyond proximity: an observational study of stillbirth rates and emergency obstetric and newborn care accessibility in The Gambia.BMJ global health · 2025Observational
- Levels and determinants of person-centred maternity care among women living in urban informal settlements: evidence from client exit surveys in Nairobi, Lusaka and Ouagadougou.BMJ global health · 2025Article
- Barriers to postnatal care utilization during the COVID-19 pandemic: a cross-sectional study of sociodemographic and spatial factors in Mexico City.Frontiers in global women's health · 2025Article
- Inequalities in geographical access to emergency obstetric and newborn care.Bulletin of the World Health Organization · 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
- Advancing the frontiers of geographic accessibility to healthcare services.Communications medicine · 2023Article
- Revealed versus potential spatial accessibility of healthcare and changing patterns during the COVID-19 pandemic.Communications medicine · 2023Article
- A geospatial database of close-to-reality travel times to obstetric emergency care in 15 Nigerian conurbations.Scientific data · 2023Article
- Prevalence, influencing factors, and outcomes of emergency caesarean section in public hospitals situated in the urban state of Lagos, Nigeria.African health sciences · 2023Article
- Neonatal and perinatal mortality in the urban continuum: a geospatial analysis of the household survey, satellite imagery and travel time data in Tanzania.BMJ global health · 2023Article
- Distance to Multidisciplinary Team Clinic in Gaborone, Botswana, and Stage at Cervical Cancer Presentation for Women Living With and Without HIV.JCO global oncology · 2022Article
- Travel of pregnant women in emergency situations to hospital and maternal mortality in Lagos, Nigeria: a retrospective cohort study.BMJ global health · 2022Article
- Tale of 22 cities: utilisation patterns and content of maternal care in large African cities.BMJ global health · 2022Article
- Leveraging big data for improving the estimation of close to reality travel time to obstetric emergency services in urban low- and middle-income settings.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Previous efforts to estimate the travel time to comprehensive emergency obstetric care (CEmOC) in low- and middle-income countries (LMICs) have either been based on spatial models or self-reported travel time, both with known inaccuracies. The study objectives were to estimate more realistic travel times for pregnant women in emergency situations using Google Maps, determine system-level factors that influence travel time and use these estimates to assess CEmOC geographical accessibility and coverage in Lagos state, Nigeria. Data on demographics, obstetric history and travel to CEmOC facilities of pregnant women with an obstetric emergency, who presented between 1st November 2018 and 31st December 2019 at a public CEmOC facility were collected from hospital records. Estimated travel times were individually extracted from Google Maps for the period of the day of travel. Bivariate and multivariate analyses were used to test associations between travel and health system-related factors with reaching the facility >60 minutes. Mean travel times were compared and geographical coverage mapped to identify 'hotspots' of predominantly >60 minutes travel to facilities. For the 4005 pregnant women with traceable journeys, travel time ranges were 2-240 minutes (without referral) and 7-320 minutes (with referral). Total travel time was within the 60 and 120 minute benchmark for 80 and 96% of women, respectively. The period of the day of travel and having been referred were significantly associated with travelling >60 minutes. Many pregnant women living in the central cities and remote towns typically travelled to CEmOC facilities around them. We identified four hotspots from which pregnant women travelled >60 minutes to facilities. Mean travel time and distance to reach tertiary referral hospitals were significantly higher than the secondary facilities. Our findings suggest that actions taken to address gaps need to be contextualized. Our approach provides a useful guide for stakeholders seeking to comprehensively explore geographical inequities in CEmOC access within urban/peri-urban LMIC settings.
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