The Space Accessibility Analysis Of Measles Vaccination Of Children In Rural Area Of Guangxi

Section ? : The spatial configuration of village and township hospital in GuangxiObjective To study the spatial allocation of Guangxi towns and townships hospitals, evaluate the rationality of the layout of the study areas, and provide scientific decision basis for the health sector to the optimization of grassroots health institutions.Methods Based on the data of village or township administrative boundary maps, spatial position of measles vaccination facilities, center of the administrative villages and traffics of the study areas,building the geometric network database in ArcCatalog, then importing into ArcMap for spatial analysis and visualization, to draw thematic maps of the towns and townships hospitals'location, network structure, maximal coverage of health clinics in towns and townships.Results (1)The number of towns(townships) hospitals sare sparse in northeast of Longan, center and west of Zhaoping, south of Wuxuan and Longlin;besides Longlin,most other county's towns(townships)' hospitals are located on the positions where deviate from the center of towns;(2)The proportion of prefectural highway and country highway are different among the 4 counties, prefectural highway in southeast of Longan are sparse than northwest,but which pass Gutan and Pingshan Villages are less; prefectural highway locate in the east of Zhaoping are dense,but which pass the townships of XianHui Yao,Muge and Fenghuang towns are relatively less; the prefectural highway of Wuxuan are more in the western and less in the eastern, only a small part of one prefectural highway passes Dongxiang; the proportion of prefectural highway in Longlin is far less than the dense of country roads ; (3) There are 25.50%,21.12%, 12.43% and 21.12% of potential measles occurrence points outside the 30 minutes coverage of the existing hospitals in Longan,Zhaoping, Wuxuan and Longlin respectively.Chengxiang hospital(22.22%) located in the northeast of,Gutan hospital(57.14%) located in the southeast and Pingshan hospital(28.57%) in the southwest have smaller coverages in Long'an; Zouma hospital(6.67%) located in the northeast, Wujiang center hospital(50%) in the south have the smaller coverages in Zhaoping; Ertang hospital in the north (63.33%)and Huangmao hospital(57.14%) in the north-central have smaller coverage in Wuxuan.There is a obvious difference between north and south about coverage of hospitals in Longlin with a greater , Yacha hosipital( 12.50%) and Tianshengqiao hospital and its Yanchang health clinic ( 42.86% ) in the northwest, Jinzhongshan hospital in the southwest(30%)have smaller coverage.Conclusions Rationality health institutions distribution of Guangxi rural area remains to be further optimized, except for adjusting the geographical spatial arrangements of health institutions, several supplementary means should be adoptted to achievie optimal allocation of health resources indeed, such as strengthing the construction of the rural road network, developing the economic and culture, capital investment, policy support and so on.Section ? : The space accessibility analysis of timely and completely measles vaccination of children in rural area of GuangxiObjective Studying the spatial accessibility of measles vaccination for children in rural areas of Guangxi, and providing theoretical basis for health decision department to evaluate and invest into medical and health cause.Methods According to the determined scale(1:100) and speed of all levels of road network, calculating the actual distance and time of every level of road,and constructing traffic network model based on actual road network, using Shortest Path Analysis to calculate the shortest path and the minimum travel time and distance from each health hospital to the administrative village center,using Service Area Analysis to solve the 5 km service range of each towns(townships) health hospital, using the Accessibility Analysis based on minimum impedance to solve overall accessibility of survey areas.Finally, comparing and analyzing these research results with immunization rates from field survey.Results (1)The results of Shortest Path Analysis show:the accessibility of Pingshan and its internal Wenhua village is the worst in Longan,the accessibility of Beituo and its internal Guanyin village is the worst in Zhaoping, the accessibility of Huangmao and its internal Shangwen village is the worst in Wuxuan, the accessibility of Pingban and its internal Gonghe village is the worst in Zhaoping;(2) A service range of 26 km, 20 km, 18 km and 26 km can basically meet the need of all administrative villages in Longan County, Zhaopin g County, Wuxuan County and Longlin County respectively.The minimum coverage of 5 km service range of each towns(townships)' hospital in each county is 33.3%, 33.3%, 33.3% and 28.57% respectively; (3) Timely and completely measles vaccine of Pingshan ( 52.54%) and its internal Qunli village(20% ) is lowest in Longan, timely and completely measles vaccine of Beituo(43.33%)and its internal Lijiao village(20%)is lowest in Zhaoping, timely and completely measles vaccine of Siling (27.59%) and its internal Guzhang village(0.00% ) is lowest in Wuxuan, timely and completely measles vaccine of Longhuo (32.14%) and its internal Diyan village (12.5%) is lowest in Wuxuan.Conclusions Although the average accessibility of the 4 counties are comparatively well, but due to the difference in topography,landforms,economic development, the development of the culture and education level,leading to the accessibility of these areas are unequal, so it is suggested that superior departments should take measures to explore in-depth, find the cause of poor accessibility, suit the remedy to the case,and improve the accessibility and fairness to access medical care in each area.