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Scientific article
Open access
English

Travel scenario workshops for geographical accessibility modeling of health services: A transdisciplinary evaluation study

Published inFrontiers in public health, vol. 10, 1051522
Publication date2023-01-18
First online date2023-01-18
Abstract

Introduction: Limited geographical access to quality Emergency Obstetric and Newborn Care (EmONC) is a major driver of high maternal mortality. Geographic access to EmONC facilities is identified by the global community as a critical issue for reducing maternal mortality and is proposed as a global indicator by the Ending Preventable Maternal Mortality (EPMM) initiative. Geographic accessibility models can provide insight into the population that lacks adequate access and on the optimal distribution of facilities and resources. Travel scenarios (i.e., modes and speed of transport) used to compute geographical access to healthcare are a key input to these models and should approximate reality as much as possible. This study explores strategies to optimize and harmonize knowledge elicitation practices for developing travel scenarios.

Methods: Knowledge elicitation practices for travel scenario workshops (TSW) were studied in 14 African and South-Asian countries where the United Nations Population Fund supported ministries of health and governments in strengthening networks of EmONC facilities. This was done through a mixed methods evaluation study following a transdisciplinary approach, applying the four phases of the Interactive Learning and Action methodology: exploration, in-depth, integration, and prioritization and action planning. Data was collected in November 2020-June 2021 and involved scoping activities, stakeholder identification, semi-structured interviews (N = 9), an evaluation survey (N = 31), and two co-creating focus group discussions (N = 8).

Results: Estimating realistic travel speeds and limited time for the workshop were considered as the largest barriers. The identified opportunities were inclusively prioritized, whereby preparation; a favorable composition of attendees; validation practices; and evaluation were anticipated to be the most promising improvement strategies, explaining their central place on the co-developed initial standard operating procedure (SOP) for future TSWs. Mostly extensive preparation-both on the side of the organization and the attendees-was anticipated to address nearly all of the identified TSW challenges.

Conclusion: This study showed that the different identified stakeholders had contradicting, complementing and overlapping ideas about strategies to optimize and harmonize TSWs. Yet, an initial SOP was inclusively developed, emphasizing practices for before, during and after each TSW. This SOP is not only relevant in the context of the UNFPA EmONC development approach, but also for monitoring the newly launched EPMM indicator and even in the broader field of geographic accessibility modeling.

eng
Keywords
  • Geographic accessibility
  • Maternal health
  • Emergency obstetric care
  • Travel scenario
  • Interactive learning
  • Accessmod
  • Emergency Medical Services
  • Female
  • Health Facilities
  • Health Services Accessibility
  • Humans
  • Infant, Newborn
  • Maternal Mortality
  • Pregnancy
  • Travel
Citation (ISO format)
MOLENAAR, Lotte et al. Travel scenario workshops for geographical accessibility modeling of health services: A transdisciplinary evaluation study. In: Frontiers in public health, 2023, vol. 10, p. 1051522. doi: 10.3389/fpubh.2022.1051522
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Identifiers
ISSN of the journal2296-2565
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Technical informations

Creation01/18/2023 10:31:00 AM
First validation01/18/2023 10:31:00 AM
Update time03/16/2023 10:37:00 AM
Status update03/16/2023 10:36:59 AM
Last indexation05/06/2024 3:22:21 PM
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