ArticleInternational journal for equity in health2025
Empowering access: unveiling an overall composite spatial accessibility index to healthcare services in Southeastern Iran.
Article in International journal for equity in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Examining the association between spatial accessibility to emergency cardiac care centers and cardiovascular mortality in Georgia, United States.BMC cardiovascular disorders · 2026Article
- Article
- Evidence-Based Planning of High-Complexity Healthcare Networks at National Level: Integrating Mortality Records, Accessibility Metrics, and Facility Location Optimization Models.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- National program for cardiovascular disease and hypertension in primary healthcare: WHO-PEN program initial scale-up in Iran (IraPEN).BMC cardiovascular disorders · 2026Article
- Spatial accessibility and equity analysis of designated medical insurance pharmacies in China.BMC health services research · 2026Article
- A structured approach to promote equity in spatial accessibility to TB services during private sector engagement.IJTLD open · 2026Article
- Prevalence of Poor Sleep Quality and Associated Factors Among Nurses in Southeast Iran: A Cross-Sectional Study.Health science reports · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundAccess to healthcare is critical for population health; however, geographic barriers persist especially in rural and deprived regions. This study aims to develop an overall composite potential spatial accessibility index to healthcare facilities and services in Sistan and Baluchestan Province in southeast Iran.
methodsThis study employed the enhanced two-step floating catchment area (E2SFCA) method to create an overall composite spatial accessibility index for healthcare facilities and services in Sistan and Baluchestan Province, southeast Iran. Spatial accessibility for general practitioners, nursing, dentistry, midwifery, pharmacy, medical laboratory, nutrition, public health, radiology, psychology, environmental health, rural health workers, inpatient hospital beds, and five medical specialty services were calculated. Spatial accessibility scores were normalized from 0 to 1 (no access = 0, low = 0.01 to 0.33, moderate = 0.331 to 0.66, high = 0.661 to 1) and aggregated into overall indices of primary, secondary, and overall healthcare accessibility for each district. Inequality was assessed using the Lorenz curve and Gini coefficient analysis.
resultsLow geographic accessibility was found across Sistan and Baluchestan Province, especially in rural areas. Almost 75% of the population had low/no access to overall primary care services within a 30-minute drive time. For secondary care, nearly 45% had low/no access to hospital inpatient beds within a 30-minute drive time, and around 40% had low/no access to specialists within a 60-minute drive time. Just 11.6% of the population had high overall healthcare access. The calculated Gini coefficient of 0.517 for the overall spatial accessibility index to healthcare services in Sistan and Baluchestan Province highlights a highly unequal distribution of healthcare services.
conclusionsThis study demonstrates a useful replicable methodology that combines individual service accessibility metrics into an overall spatial healthcare access index. Furthermore, this study provides evidence of major shortfalls in healthcare access across Sistan and Baluchestan Province. Targeted strategies are required to increase the availability and capacity of services in underserved communities. Improving geographic access is key for progressing towards universal coverage and better population health.
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