A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran

• Main Authors: Zahra Mohammadi Daniali (Author), Mohammad Mehdi Sepehri (Author), Farzad Movahedi Sobhani (Author), Mohammad Heidarzadeh (Author)
• Format: Book
• Published: Korean Society for Preventive Medicine, 2022-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1975-8375; 2233-4521; 10.3961/jpmph.21.401
• Keywords: maternal neonatal care; regionalization; geographical location; healthcare facility; health equity; public health; Medicine; R; Public aspects of medicine; RA1-1270
• Source: Journal of Preventive Medicine and Public Health, Vol 55, Iss 1, Pp 49-59 (2022)

Objectives Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.