Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

中文翻译：

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使用前瞻性方法确定有利于理解医疗保健可及性差异的实地考察地点

本文的核心是选择实地考察可以更好地理解医疗保健可及性差异的地点的问题。获得医疗保健对身体健康至关重要，但居民可能会遇到医疗保健障碍，限制了他们获得所需护理的能力。低收入国家的大多数居民需要沿着蜿蜒的小路长途跋涉才能获得医疗保健服务。马拉维的个人回答了一项调查，其中提出了一系列关于在获得医疗保健服务方面存在困难的问题。使用垂直和水平阻抗，我们为样本中的个人与其使用的医疗保健中心之间的家庭位置之间的步行时间建模。数字高程模型和 Tobler 的徒步功能用于表示垂直阻抗，而 OpenStreetMap 与土地覆盖图集成用于表示水平阻抗。结合马拉维步行时间和感知可达性的测量，我们使用空间统计数据并发现空间集群在医疗服务可达性方面存在巨大差异，这代表了有利于更好地了解医疗服务障碍的实地工作地点。