Cluster and Buffer Analysis of the Distribution of Healthcare Facilities in Plateau State

Abstract

Nigeria faces significant challenges in providing access to healthcare services for its population. An important aspect of Nigerian health policy that requires timely evaluation, is accessibility to Primary Health Care (PHC) facilities (and, indeed, other healthcare facilities) especially in rural areas. Thus, the need to investigate their distribution and spatial influence. This study employed the technology of Remote Sensing and GIS in generating relevant scientific data on the spatial distribution of healthcare facility in Plateau State. Coordinates of various health facilities were recorded using handheld GPS while various attribute information were also obtained and recorded. The results thus acquired were tabulated and segmented by local government. The type of facility (primary, secondary and tertiary) and, ownership (government or private) was tabulated and prepared for further analysis. There are 1237 health facilities spread across the state. Government PHC facilities; 615, private PHC facilities; 542, government secondary and private secondary healthcare facilities; 31 and 44 respectively and 5 tertiary healthcare facilities were documented and their spatial distribution and relationship represented graphically. Buffer distances of 0.5, 1 and 2 Kilometers and 1, 2, 3, 5 and 10 Kilometers were used for buffer analysis of the spatial relationship between facilities and settlements. This showed a reasonable coverage especially around the location of settlements within the state. Urban centers present clustering of facilities due to density of population in these areas. The cluster analysis reveals similar Nearest Neighbor Ratios for all the types of facilities with private secondary healthcare having the least with 0.606858. This is a direct consequence of the clustering of private secondary facilities around the Jos-Bukuru metropolis in the northern end of the state. Other types of facility are not too far from this ratio with government primary presenting 0.701219, private primary 0.837056 and 0.661641 for government secondary facilities. The northern senatorial district shows much of this clustering with the peak in and around the Jos-Bukuru metropolis. This can be attributed to the important role of Jos as the administrative center of the state and a major urban area. The z-scores for both government (-14.174948) and private primary healthcare facilities (-15.069804) indicates significant clustering. The z-score for government secondary (-1.735602) in correlation with its relatively high Nearest Neighbour Ratio points towards the near-equitable distribution of these facilities.