title: Health-care availability, preference, and distance for women in urban Bo, Sierra Leone.
abstract: OBJECTIVE
  To examine the diversity of the health-care providers in urban Bo, Sierra Leone, identify the types of health-care facilities preferred by women for fevers, and analyze the road network distances from homes to preferred health-care providers.
  
  
  METHODS
  A population-based random sampling method was used to recruit 2419 women from Bo. A geographic information system was used to measure the road distance from each woman's home to her preferred provider.
  
  
  RESULTS
  Preferred health-care providers for acute febrile illnesses (commonly referred to as "malaria" in the study communities) were hospitals (62.3 %), clinics (12.6 %), and pharmacies (12.4 %). Participants lived a median distance of 0.6 km from the nearest provider, but on average each woman lived 2.2 km one-way from her preferred provider. Women living farther from the city center had preferred providers significantly farther from home than women living downtown.
  
  
  CONCLUSIONS
  The diverse health-care marketplace in Bo allows women to select clinical facilities from across the city. Most women prefer a malaria care provider farther from home than they could comfortably walk when ill.
authors.affiliation: Department of Environmental Science and Public Policy, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA. lflemin1@gmu.edu.
authors.forename: Lila C
authors.initials: LC
authors.lastname: Fleming
authors.affiliation: Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone.|Njala University, Bo, Sierra Leone.
authors.forename: Rashid
authors.initials: R
authors.lastname: Ansumana
authors.affiliation: Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone.
authors.forename: Alfred S
authors.initials: AS
authors.lastname: Bockarie
authors.affiliation: Information Technology Division, U.S. Naval Research Laboratory, 4555 Overlook Avenue, SW Washington, DC, 20375, USA.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Alejandre
authors.affiliation: Department of Geography and Geoinformation Science, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Owen
authors.affiliation: Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone.
authors.forename: Umaru
authors.initials: U
authors.lastname: Bangura
authors.affiliation: Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone.
authors.forename: David H
authors.initials: DH
authors.lastname: Jimmy
authors.affiliation: Department of Geography and Geoinformation Science, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Curtin
authors.affiliation: Center for Bio/Molecular Science and Engineering, U.S. Naval Research Laboratory, 4555 Overlook Avenue, SW Washington, DC, 20375, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Stenger
authors.affiliation: Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA.
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Jacobsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D005260:Female; D040362:Geographic Information Systems; D006282:Health Personnel / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008288:Malaria / Q000628:therapy; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D010593:Pharmaceutical Services / Q000706:statistics & numerical data; D012807:Sierra Leone; D014195:Travel / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Choice behavior; Health services accessibility; Sierra Leone; Urban population; West Africa