Primary Health Care Center (PHCC) Location-Allocation with Multi-Objective Modelling: A Case Study in Idleb, Syria

Spatial accessibility modeling to healthcare facilities in the case of health shocks of Midnapore municipality, India

This research aims to identify the accessibility of the entire population, especially the slum population to existing healthcare facilities (HCF) as well as the slum neighborhoods having low geographic accessibility, and finally, to provide an analytical model for the people living in areas that are outside the coverage range of existing healthcare facilities (HCF) across the study area. Spatial data has been collected and used based on the road network, elevation, location of HCF, municipal boundary, slum point, and satellite images from various sources. Also, non-spatial data such as socioeconomic variables are collected from questionnaires survey within a particular period. The spatial analysis tool like as near, network analysis, and predictive analysis in the ArcGIS platform was used to examine geographic accessibility. The results of the spatial analysis show that the distribution of public healthcare facility centers in the study area has not been uniformly distributed. Across 84% of areas in the study area have sound spatial accessibility with traveling time coverage is about 12 min. However, 16% of areas have a traveling time of 12 to 30 min under low accessibility with existing slum neighborhoods. Therefore, the low spatial accessibility areas are demanding new healthcare facilities in the study area. The Analytical Hierarchy Process (AHP) is employed to find the most optimal and efficient locational suitability for building new healthcare facility centers. The finding of AHP analysis for site suitability of healthcare facilities revealed five major classes as most suitable (2%), suitable (5%), moderate (35%), poor (54%), and very poor (4%) in the study area. Moreover, the realistic framework of this study helps to measure geographic accessibility and suitability in any geographical area.

Conflict-related health research in Syria, 2011-2019: a scoping review for The Lancet - AUB Commission on Syria

BACKGROUND

The volume of health-related publications on Syria has increased considerably over the course of the conflict compared with the pre-war period. This increase is largely attributed to commentaries, news reports and editorials rather than research publications. This paper seeks to characterise the conflict-related population and humanitarian health and health systems research focused inside Syria and published over the course of the Syrian conflict.

METHODS

As part of a broader scoping review covering English, Arabic and French literature on health and Syria published from 01 January 2011 to 31 December 2019 and indexed in seven citation databases (PubMed, Medline (OVID), CINAHL Complete, Global Health, EMBASE, Web of Science, Scopus), we analyzed conflict-related research papers focused on health issues inside Syria and on Syrians or residents of Syria. We classified research articles based on the major thematic areas studied. We abstracted bibliometric information, study characteristics, research focus, funding statements and key limitations and challenges of conducting research as described by the study authors. To gain additional insights, we examined, separately, non-research publications reporting field and operational activities as well as personal reflections and narrative accounts of first-hand experiences inside Syria.

RESULTS

Of 2073 papers identified in the scoping review, 710 (34%) exclusively focus on health issues of Syrians or residents inside Syria, of which 350 (49%) are conflict-related, including 89 (25%) research papers. Annual volume of research increased over time, from one publication in 2013 to 26 publications in 2018 and 29 in 2019. Damascus was the most frequently studied governorate (n = 33), followed by Aleppo (n = 25). Papers used a wide range of research methodologies, predominantly quantitative (n = 68). The country of institutional affiliation(s) of first and last authors are predominantly Syria (n = 30, 21 respectively), the United States (n = 25, 19 respectively) or the United Kingdom (n = 12, 10 respectively). The majority of authors had academic institutional affiliations. The most frequently examined themes were health status, the health system and humanitarian assistance, response or needs (n = 38, 34, 26 respectively). Authors described a range of contextual, methodological and administrative challenges in conducting research on health inside Syria. Thirty-one publications presented field and operational activities and eight publications were reflections or first-hand personal accounts of experiences inside Syria.

CONCLUSIONS

Despite a growing volume of research publications examining population and humanitarian health and health systems issues inside conflict-ravaged Syria, there are considerable geographic and thematic gaps, including limited research on several key pillars of the health system such as governance, financing and medical products; issues such as injury epidemiology and non-communicable disease burden; the situation in the north-east and south of Syria; and besieged areas and populations. Recognising the myriad of complexities of researching active conflict settings, it is essential that research in/on Syria continues, in order to build the evidence base, understand critical health issues, identify knowledge gaps and inform the research agenda to address the needs of the people of Syria following a decade of conflict.