J Prev Med Public Health.
2022 Jan;55(1):49-59. 10.3961/jpmph.21.401.
A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran
- Affiliations
-
- 1Department of Industrial Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- 2Department of Healthcare Systems Engineering, Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran
- 3Department of Pediatrics, Tabriz University of Medical Science, Tabriz, Iran
- KMID: 2525144
- DOI: http://doi.org/10.3961/jpmph.21.401
Abstract
Objectives
Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran.
Methods
First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties.
Results
It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider.
Conclusions
This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.
