Evidence map›Paper›PMID 41877323›Full record

ArticleBMJ open2026

Geographic barriers to gynaecological cancer care in Indonesia: a geospatial and infrastructure analysis.

Brahmana Askandar Tjokroprawiro, Hanif Ardiansyah Sulistya, Annisa Aghnia Rahma, Khoirunnisa Novitasari, Renata Alya Ulhaq, Indra Yuliati, Tofan Widya Utami, Tricia Dewi Anggraeni

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Brahmana Askandar TjokroprawiroDepartment of Obstetrics and Gynecology, Dr Soetomo Regional General Hospital, Surabaya, Indonesia brahmanaaskandar@fk.unair.ac.id.ORCID http://orcid.org/0000-0003-1658-3477
Hanif Ardiansyah SulistyaDepartment of Obstetrics and Gynecology, Universitas Airlangga Fakultas Kedokteran, Surabaya, Indonesia.ORCID http://orcid.org/0000-0002-5032-2775
Annisa Aghnia RahmaFaculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.
Khoirunnisa NovitasariDepartment of Obstetrics and Gynecology, Dr Soetomo Regional General Hospital, Surabaya, Indonesia.
Renata Alya UlhaqDepartment of Obstetrics and Gynecology, Dr Soetomo Regional General Hospital, Surabaya, Indonesia.
Indra YuliatiDepartment of Obstetrics and Gynecology, Dr Soetomo Regional General Hospital, Surabaya, Indonesia.
Tofan Widya UtamiObstetrics and Gynecology, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Indonesia.
Tricia Dewi AnggraeniObstetrics and Gynecology, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to identify underserved regions and evaluate the population coverage based on travel time and distance to hospitals with gynaecologic oncologists in Indonesia.

methodsThe travel time and distance to hospitals with gynaecologic oncologists were evaluated using the Quantum Geographic Information System. Data from 139 gynaecologic oncologists and their affiliated hospitals were obtained from the Indonesian Society of Gynecologic Oncologists (November 2024) and cross-referenced with the Ministry of Health records. The female population density data were sourced from Facebook's high-resolution settlement layer. Isochrones were generated to estimate travel times and distances using zonal statistics, which facilitated the calculation of population coverage.

resultsA total of 139 gynaecologic oncologists were identified nationwide, practising in 243 hospitals (7.6% of the 3202 hospitals in Indonesia), with a concentration in Java (60.4%). 11 of the 38 provinces lack sub-specialists. Population coverage varies sharply: the travel time to a hospital with gynaecologic oncologists is ≤2 hours for 79.1% of women in Java, compared with 4.9% in Papua; overall, 34.4% reside more than 100 km away from hospitals with gynaecologic oncologists. Hospitals with gynaecologic oncologists are predominantly urban class B general hospitals, and 83.1% participate in the National Health Insurance Schemes. Exploratory district-level correlations showed positive associations between the number of such hospitals and total female population (r=0.44, p<0.001), female life expectancy (r=0.29, p<0.001), per-capita expenditure (r=0.54, p<0.001), female population density (r=0.68, p<0.001), female Human Development Index (r=0.4, p<0.001) and a negative association with land area size (r=-0.15, p<0.001).

conclusionsGynaecological oncology services in Indonesia remain heavily concentrated in Java, leaving nearly one-fifth of women residing more than 100 km away. The travel time is greater than 2 hours for many. Targeted expansion of the gynaecologic oncologists workforce, diagnostic and treatment infrastructure, and sustainable financing mechanisms are required to close these gaps.

Indexed as

Genital Neoplasms, FemaleHealth Services AccessibilityOncologistsFemaleGeographic Information SystemsGynecologistsHumansIndonesiaMedically Underserved AreaTravelGynaecological oncologyHealth Services AccessibilityOBSTETRICS

Identifiers

PMID41877323
PMCPMC13034326

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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.