ArticleBMC pregnancy and childbirth2022
Distance is "a big problem": a geographic analysis of reported and modelled proximity to maternal health services in Ghana.
Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Trial
- Multivariable regression modelling of structural, intermediary and demographic determinants of health literacy: evidence from unaccompanied migrants and statelessness-prone individuals in Ghana.Journal of health, population, and nutrition · 2026Article
- Machine learning approaches to predict maternal anemia and Identifying associated factors among pregnant women in Sub-Saharan Africa.Journal of public health research · 2026Article
- Antenatal care in Meghalaya - An Uphill Battle: A Community-based Study of Drivers and Barriers of Antenatal Care Utilization.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Article
- Inequalities in the completion of maternal continuum of care in Ethiopia using the 2019 mini-Ethiopian demographic and health survey.Scientific reports · 2026Article
- Determinants of maternity services utilisation among women of reproductive age across sub-Saharan Africa.PloS one · 2026Article
- Association of Travel Time and Residential Location With the Use of Antenatal Care and Institutional Delivery Services in Afghanistan.Obstetrics and gynecology international · 2026Article
- Cross-context qualitative synthesis of a mobile obstetric referral emergency system (MORES) in Ghana and Liberia.PloS one · 2026Article
- Multilevel Analysis of Severe Anthropometric Failure among Under-Five Children in Benin: A Cross-Sectional Study Using 2017 to 2018 Demographic and Health Survey Data.Annals of global health · 2026Article
- Heatwaves and Home Births: Understanding the Impact of Extreme Heat on Place of Delivery in India.GeoHealth · 2025Article
- Geospatial analysis of preterm and small-for-gestational age births in Washington D.C.BMC pregnancy and childbirth · 2025Article
- Persistence of geographic barriers to maternal care services following a health system strengthening initiative in rural Madagascar.BMC pregnancy and childbirth · 2025Article
- Mapping Geographic Disparities in Healthcare Access Barriers Among Married Women in Pakistan: Evidence from a Nationally Representative Survey.Healthcare (Basel, Switzerland) · 2025Article
- Application of machine learning algorithms and SHAP explanations to predict fertility preference among reproductive women in Somalia.Scientific reports · 2025Article
- Individual and community level determinants of unmeet pregnancy complication education among pregnant ANC visitor women in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey.BMC pregnancy and childbirth · 2025Article
- Assessing the impact of building footprint dataset choice for health programme planning: a case study of indoor residual spraying (IRS) in Zambia.International journal of health geographics · 2025Article
- Article
- Effect of trust in village health workers on the use of facility-based follow-up postnatal care services in two districts in the Lao People's Democratic Republic.Tropical medicine and health · 2025Article
- Determinants of attendance in antenatal care clinics in rural settings in Mali and Burkina Faso: a cross-sectional study.BMC pregnancy and childbirth · 2025Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundGeographic barriers to healthcare are associated with adverse maternal health outcomes. Modelling travel times using georeferenced data is becoming common in quantifying physical access. Multiple Demographic and Health Surveys ask women about distance-related problems accessing healthcare, but responses have not been evaluated against modelled travel times. This cross-sectional study aims to compare reported and modelled distance by socio-demographic characteristics and evaluate their relationship with skilled birth attendance. Also, we assess the socio-demographic factors associated with self-reported distance problems in accessing healthcare.
methodsDistance problems and socio-demographic characteristics reported by 2210 women via the 2017 Ghana Maternal Health Survey were included in analysis. Geospatial methods were used to model travel time to the nearest health facility using roads, rivers, land cover, travel speeds, cluster locations and health facility locations. Logistic regressions were used to predict skilled birth attendance and self-reported distance problems.
resultsWomen reporting distance challenges accessing healthcare had significantly longer travel times to the nearest health facility. Poverty significantly increased the odds of reporting challenges with distance. In contrast, living in urban areas and being registered with health insurance reduced the odds of reporting distance challenges. Women with a skilled attendant at birth, four or more skilled antenatal appointments and timely skilled postnatal care had shorter travel times to the nearest health facility. Generally, less educated, poor, rural women registered with health insurance had longer travel times to their nearest health facility. After adjusting for socio-demographic characteristics, the following factors increased the odds of skilled birth attendance: wealth, health insurance, higher education, living in urban areas, and completing four or more antenatal care appointments.
conclusionStudies relying on modelled travel times to nearest facility should recognise the differential impact of geographic access to healthcare on poor rural women. Physical access to maternal health care should be scaled up in rural areas and utilisation increased by improving livelihoods.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.