title: A geographic analysis of access to health services in rural Guatemala.
abstract: This paper uses road network analysis to quantify access to health care services in Alta Verapaz, a rural district in Guatemala with a majority Mayan population. Population data from the 2002 Guatemalan census, the location of health care facilities from the Ministry of Public Health and Social Assistance, and road and trail locations from the National Geographic Institute were included in a geographic information system (GIS). We computed the shortest path from each populated place to the nearest health care facility and then estimated the approximate travel time to the health facility based on road surface type. Road network analysis found that approximately 38.1% of residents of Alta Verapaz live within one hour of a hospital and 76.8% live within one hour of a basic care facility. In comparison, a circular buffer method found that 27.5% had access to a hospital and 94.5% had access to a primary care facility. Poverty was correlated with reduced access to care. The use of models that adjust for road types and allow for accurate estimation of travel times are helpful tools to identifying populations with limited access to health care services.
authors.affiliation: Department of Geography and Geoinformation Sciences, George Mason University, Fairfax, Virginia 22030, USA.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Owen
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Obregón
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Jacobsen