health casestudy

8/9/2019 Health CaseStudy

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Healthcare Master Plan of Lao PDRHealthcare Master Plan of Lao PDR

Identify Potential Location forIdentify Potential Location for

Health Centers (primary care)Health Centers (primary care)

(I)(I)


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China

Vietnam

Thailand

Cambodia

Population 5 Million

Land Area 237,000 sq km

Vientiane


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Topography


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Population Density


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Hours

Travel Time from District Hospital to

Provincial Hospital

Dry Season

Hours

Rainy Season

Facility Based Survey-JICA 2002


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I . Locate new Health Center

Analysis

SocialSupply

Query

Locate poor districts

Village

Pop. density

Travel time

(village to DH)Existing

Health Center

Potential Locations


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Factors used to evaluate poor districts,

Supply:- Availability of qualified medical staffs (MD,MA,Nurse)

- Accessibility in dry/wet season

- Availability of X Ray machines

- Availability of operating theaters

Social:

-Availability of clean water

-Availability of latrine-Literacy

-Availability of electricity


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Query with criteria of Supply FactorsQuery with criteria of Supply Factors

MD not 0 or MD >=2 & MA >= 2& Nurse >= 2

YesNo

YesNo

Travel time to PH in Dry & Rainy season < 6 Hrs.

X-Ray & Operation are available

YesNo

Poor DH

Go to

PH

Poor DHGood DH


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Data Source

National Boundary Geography Department

Provincial Boundary Geography Department

District Boundary Geography Department

Village Location UXO Project

Roads Ministry of Transport

Topography Mekong River

CommissionHealth Facility Location MOH

SPATIAL DATA


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No Description of Data Representation Source

1 Population Growth Province Agriculture Statistics

2 Household Income Province Agriculture Statistics

3 Household Consumption Province Agriculture Statistics

4 Births Province Agriculture Statistics

5 Medical Expenditure Province Agriculture Statistics

6 Transportation Expenditure Province Agriculture Statistics

7 Piped water availability Province Agriculture Statistics

8 Infant Mortality Province Agriculture Statistics

9 Immunization Province Agriculture Statistics

10 Latrine Availability Province Agriculture Statistics

11 Health Development Province Agriculture Statistics

DESCRIPTIVE DATA


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%of household with clean water < 50

YesNo

YesNo

YesNo

YesNo

Poor Social

% of household without latrine > 50

% of literacy population < 50

% of household with electricity < 50

Poor

Poor access

Query with criteria of Social FactorsQuery with criteria of Social Factors


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There are 15 districts far away

from Provincial hospital more than 6 hrs.

Query PH to DH > 6 hrs.


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([Umd] < 2) and ([Mma] < 2) and ([Mnurs] < 2) or([Umd] = 0)

Query qualified medical staffs


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Query not available facilities

[X-ray] = 0 and [Oper] = 0


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All the supply factors are not available


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Assume 50% as the

cutoff value

94 districts falling

inpoorsocial

factors

Social factors

([Wt_phh] < 50) and ([Tl-N_phh] > 50) and

([Lt-Y_ppp] < 50) and ([El_phh] < 50)


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These steps are to find the most poor district

in social and supply factors

([Wt_phh] < 50) and ([Tl-N_phh] > 50) and

([Lt-Y_ppp] < 50) and ([El_phh] < 50) and

([Supply] = "NA")


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3.Locate the most suitable area for new health center

Create village population density for Dakchun district

Create surface of village travel time to district hospitals

Load exist health centers and buffering

Analyst to locate the most suitable area for new health center

Once we have finished the previous steps, some districts are recognized

as poor and remote. In this taskDakchun district is selected to analyzeto find location for new health center to improve health situation.

Steps:

Criteria:

(i) Highly population areas need more attention(ii) Distance to district hospital is a priority

(iii)Away from any health facility (Health

center,District hospital) need to consider


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Hours

Travel Time to Dakchun DH

DH

HC



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Reclassify travel time grid to 3 classes

Low, Time 1 day


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Population distribution - Dakchun

Person

DH

HC



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Reclassify Population Density into 4 classes (High, Medium, Low and Nodata)

Low density, Pop. 50 person/Sq.km


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Create buffer 2 Km. to Health center and 5 Km. for District Hospital

Buffer of existing health centers and district hospital


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Convert buffer to grid


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1.Travel time grid 3 classes

Low, Time 1 day

Low density, Pop. 50 person/Sq.km

2.Population Density grid classes (High, Medium, Low and Nodata)

3.Existing health center& district hospital buffer grid 2 classes

Inside buffer = area within health services

Outside buffer = away from any health services

Combined all the factors in GIS environment


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Analysis for combination of Population density, Travel time to DH

and Existing DH

Time

B

A

Pop.Den

(H)

3

(M)

2

(L)

1

(H)

30 33 32 31

(M)

2023 22 21

(L)

1013 12 11

In the previous steps we have created3 grids Population density , Travel time to district hospital

and Buffer of existing health facilities. To evaluate most suitable areas for need facility, we could

compile these 3 grids, consider numerical evaluation of these as A+B x C. Population density is

assigned 30,20 and 10 in highest to lowest order. 1,2,3 is assigned to time depicting relative time from

village to DH. Inside, Outside buffer zone of HC is assigned with the said evaluation, the resultant

grid will have 0 or some value. 0 inside buffer is less priority.Value represent the priority scale (33,32, 31, 23, 22, 21, 13, 12, 11)

1 1 1

1 0 1

1 0 0

33 32 31

23 0 21

13 0 0

X =

Suitable Not suitable

Outside buffer

Inside buffer

Most suitable

C


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([Time2dh_cls] + [Popden_cls])


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[Time_pop]*[Buffer-g2]

Exclude existing HF service area


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Ranking Result for most suitable location

Least Suitable

Most Suitable


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Calculate population in healths service area(addition)


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Thank You

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