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Geospatial Network Analysis for Healthcare Facilities Accessibility in Semi-

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Conference Paper · March 2018

DOI: 10.1109/CSPA.2018.8368722

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 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia

Geospatial Network Analysis for Healthcare

Facilities Accessibility in Semi-Urban Areas
Ilham Abd Jalil, Abdul Rauf Abdul Rasam, Nor Aizam Adnan, Noraain Mohamed Saraf, Ahmad Norhisyam Idris
Centre of Studies for Surveying Sciences and Geomatics
Faculty of Architecture, Planning and Surveying
University Teknologi MARA, Malaysia
rauf@salam.uitm.edu.my, ilhamabdjalil@gmail.com, nor_aizam@salam.uitm.edu.my,
noraainms@salam.uitm.edu.my, ahmad_norhisyam@salam.uitm.edu.my

Abstract - Healthcare facilities in developing countries are
mostly located in urban or semi-urban areas rather than in rural
areas, causing inconvenience to the residents to reach clinics as
occurred in Pulau Indah Klang, Malaysia. Therefore, a
comprehensive analysis of the healthcare service is conducted in
this area by utilising geospatial network analyst, vector analysis
and spatial criteria. The main intentions of this study are to find
the optimum route to the nearby healthcare facilities and to
recommend suitable sites to build a new location of the facility in
the island. Data collection are composed of spatial and attributes
data such as road access, lists of healthcare facilities, the type of
healthcare facilities, travelling time, cost, as well as base maps
from Google Earth. The finding shows only one main clinic is
located in this island, and it may have a limited space and medical
services to support the local health needs. Hence, spatial network
analyses are conducted to assist the local community to find an
optimum accessibility to reach ideal healthcare centres especially
in peak time. The study has also suggested a suitable site for a
location of healthcare facility in order to adequately cover the
community.
Keywords – healthcare facility; network and accessibility;
geospatial; GIS; urban and rural
I. INTRODUCTION
Healthcare facilities are places that provide treatment to
the community who need it such as include clinics, hospitals,
outpatient care centres and specialized care centres. These
facilities provide various medical services to the publics.
There has been a reestablishment of enthusiasm for
geographical features within public health, mainly in local
community development and international health. It can be
distinguished between urban and rural healthcare facilities,
especially healthcare accessibility, cost, geographical
services.
One of the essential purpose of proper medicinal services
is every community should have equivalent opportunity to go
to healthcare facilities. To meet this agenda, health authorities
are required to identify whether individuals have accessible
route to medicinal centres. [1] stressed on the significance of
equal distribution of medicinal facilities is to make individual
can access to the greater the accessibility. The other aspects
need to take into consideration are distance, time or
economical cost, adequate design, planning, management and
maintenance of the facilities [9].
For instance, the lack of medicinal or healthcare
availability in the area around Pulau Indah can limit the people
who require finding healthcare facilities in emergency cases.
Most of them are given location by means of a particular
transportation system [14]. The system is normally estimated
in term of travel distance, time or cost. The less time and cash
spent in movement of travel, the more exercises that can be
come to in a given measure of time healthcare facilities that
located around the Port Klang area and currently only one
general healthcare facility placed in Pulau Indah.
In geographical perspective, an essential mapping aspect
is needed to find finding the places of existing facilities in a
map to decide the regions of impact and administration of
those facilities. This sort of analysis demonstrates the covering
of impact and any voids that need filling and thusly warrant the
arrangement of other facilities [15]. A proper healthcare
analysis system is help to comprehend the issues that rural
communities look in getting to quality, moderate health care
and prompting more advantageous lives. To make cautious
analysis about the genuine request and supply of healthcare
facilities at their area, each types of this analysis can be carried
out by a geospatial approach, particularly using geographical
information system (GIS) network analysis.
A GIS is a system supported by computer for capturing,
storing, querying, analysing and displaying geospatial data.
The enormous capability of GIS to profit the healthcare
industry is a little while ago starting to be figured it out. Both
open and private sector create inventive approaches to outfit
the spatial information combination and spatial representation
power. GIS determines a basic part in figuring out where and
when to intercede, enhancing the nature of care, expanding
openness of service accessibility, discovering more practical
delivery modes, and persistent secrecy of patient data while
fulfilling the necessities of the research group for information
of accessibility. [13]. Accessibility means ease with which a
facility or location can be reached from other locations.
Accessibility focuses on the investigation of healthcare centres
accessibility using geospatial techniques. Four objectives are
conducted in this study:

978-1-5386-0389-5/18/$31.00 ©2018 IEEE 255

 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia
• To create a database and map of healthcare facilities
distribution in Pulau Indah, Klang.
• To determine the shortest path and optimum
healthcare accessibility from residential areas based
on the common situation of local distance, travel time
and cost.
• To determine optimum accessibility to selected
healthcare facility (such as Hospital Tengku Ampuan
Rahimah; HTAR) based on the real situation of local
distance, travel time and cost.
• To identify suitable sites to build a new healthcare
facility in Pulau Indah based on selected criteria.
II. REVIEW ON GIS APPLICATIONS IN MANAGING HEALTHCARE
FACILITIES
A. Healthcare Facilities and Network Accessibilities
In Malaysia, medicinal services are principally under the
obligation of the administration's Ministry of Health. In
general, the country has a productive and across the board
arrangement of healthcare services, operating a two-stage
healthcare system consisting of both a co-existing private
healthcare system and a government-run universal healthcare
system. With an increase and maturing population, the
government inspires to enhance in improving of existing
building, hospitals and equipping new hospitals, improvements
in training and expansion of tele-health, and expansion of the
number of polyclinics. A noteworthy issue with the healthcare
services part is the absence of medical centres for rural
regions, which the government is attempting to counter
through the improvement of a development of a framework
called 'tele-primary care'.
According to [13], healthy communities and access to
main healthcare services are huge aspects affecting monetary
advancement and thriving. Since geographical access is an
overall healthcare system, it is important for health researchers
to develop precise measures for countries. The measures go
past nearby accessibility of healthcare services benefits inside
a province and record for travel impedance by means of
separation reduced healthcare services accessible open all
through the state. It shows of how spatial accessibility
measures can be advantageously used to assess of strategies
demonstrative of changes in the provision of healthcare
administrations.
Accessibility is focussed on the open chances that a person
at a given area has to take an interest in specific exercises.
Fundamentally, accessibility shows to the simplicity with
which exercises might be come to from a given area by
methods for a specific transportation system [14]. It is
typically estimated in term of travel distance, time or cost. The
less time and cash spent in travel, the more exercises that can
be come to in a given measure of time and the more prominent
the accessibility or effective ways.
The significance of enhancing healthcare facilities
likewise should be underlined, for example, sufficient design,
256
planning, management and maintenance of these facilities.
They are likewise basic if national government is to plan the
allotment of assets and to ensure that a high calibre of
medicinal services is conveyed to the most extreme number of
individuals at minimum cost. There a few powerful methods
for deciding the area of a new facility; one of them is by
utilizing a base map of the district and region, on which one
can enter, decipher and contrasting the information.
C. GIS for Healthcare Facilities Accessibility
Accessibility to healthcare in this study will focus on the
assessment of people have easy access to medicinal centre
services. [1] stated that the prominence of equal distribution of
healthcare facilities in a given area is crucial aspect, hence
factors which hinder an individual’s access to these health
centres are the main concern in this study. [2] explained the
factors affecting access to healthcare supply can be grouped as
socio organizational and geographic factors. The social and
organizational factor which influences medicinal services
accessibility is taken from the attributes services which involve
cost, policy, and specialization of healthcare supplier.
Generally, the importance of viable accessibility as described
in www.ukessays.com, which includes the accompanying
perspectives:
• Whether a particular healthcare facility is always
available or open
• Whether it is communally or financially available
to people
• Whether a person’s time or distance to the
facilities permits him to use the services provided
by the health authorities concerned.
A successful accessibility stresses if a people have access
to certain healthcare facilities within simple reach with no
obstructions going from transports, any financial hindrances or
separation to a health centre. The economic barrier depends
for the most part on the idea of the medicinal centre services.
[4]. In general, many aspects affect a community’s ability to
access relevant levels of healthcare. Referring to [12],
effective accessibility can be categorized into three classes:
• Availability
• Acceptability & Affordability
- Gender, Age
- Cost
- Ethnicity, Religious
• Geography
[5] expressed that the utilization of GIS for the estimation
of physical accessibility is entrenched and has been connected
in numerous territories including transport investigation, retail
site analysis, crisis healthcare management. GIS is appropriate
to estimating spatial accessibility and availability to healthcare
as they contain the center segments required for such spatial
examination, specifically:
 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia
• Data capturing storage, management and
manipulation tools for both spatial and attribute
(textual) data
• Programming environments to customize and extend
existing algorithms and create new analysis tools
• Core analysis algorithms such as buffering, overlay,
proximity analysis, shortest path and raster cost-
distance analysis
• Mapping and visualization tools to communicate the
results of analysis
Specifically, GIS has been using in many applications
geographic accessibility to primary healthcare centres [2, 6,
7,8,10 and 11]. [2] demonstrated that GIS and spatial data can
be used for determining the optimum distance to healthcare
services especially in driving time category, population
number on the served area by healthcare in the driving
scenario and others. In addition, [7] showed that a GIS can
propose new sites for locating healthcare centre by following
WHO guideline, while [8] determined new route definition
from the deprived area in emergency case.
III. DATA AND METHODS
Four main steps applied in this study include planning, data
collection, data processing, data analysis and applications.
This study only focuses on personal cars as a case study as
majority of local community have own these standard cars.
Calculation of accessibility parameters such as cost, distance,
speed and time are estimated according to the guideline of
Land Public Transportation Commission of Malaysia (SPAD,
2015).
A. Planning of Study
A suitable study area and approach selection needs to be
determined correctly to produce accurate results. Pulau Indah,
Klang, Malaysia was selected as a study area due to limitation
of healthcare facilities and to understand the problems that the
communities faced in accessing quality, affordable to health
care and leading healthier lives. ArcGIS 10.4 used to integrate
most common spatial data, such as the local health authorities,
residential area, and statistic traffic road.
B. Data Collection
Data used can be categorised into two types; data spatial
and data attribute. Data spatial are data were generated from
Google Map, Waze Application, ERDAS IMAGINE, ArcGIS
to create a base map of the study area. Residential data were
obtained from Department of Statistics Malaysia. List of
healthcare facilities was collected from Selangor State Health
Department, while road data was taken from map of Klang and
speed limit data was obtained from Land Public Transport
Commission (SPAD). The image of the study area was
collected from the satellite image via Google Earth. Barrier
data of travel car were derived from Waze Application and
257
outdoor survey. These barrier data are needed to know the
exact spot that obtained from any unexpected incident on road
that causes heavy traffic along the analysis path.
Data attribute covers lists of healthcare facilities, type of
healthcare facilities, address, and type of service, lists of
residential area, name of all of the housing areas in Pulau
Indah, barrier, road network, road distance, road name, type of
road, speed limit, and cost and travel time.
C. Data Processing
Data editing, processing and analysis performed in ArcGIS
Network Analyst. Buffering analysis was applied to analyse
which site is suitable to locate new healthcare facilities. In
order to choose suitable location of healthcare site, the analysis
was carried out using guidelines from District Health Facilities
by World Health Organization [15]. The healthcare facilities
must be located within 4 kilometer from residential area and
the healthcare facilities distance not more than 200 meters
from major road.
There are also three main processes applied in this task
mainly data entry, georeferencing, recify, and mosaicing. Data
entry is the process to import data into ArcGIS. All data had
been projected in Rectified Skew Orthomorphic Natural
Origin projection and projected into Kertau (RSO) RSO
Malaya (meters) projection, then for the data coordinate of the
certain place was taken from Google Earth and recorded.
Then, data editing process was conducted for correction
of errors during the digitization process. The purpose of
this process was to update the process of digitization has
been done in terms of error over-or under the line and
polygon correction.
D. Data Analysis and Applications
Geospatial network analyst and overly analysis are the
main tool to do data analysis for this study. Several analysis
feature are using in this network analyst tool such as new route
and location allocation.
IV. RESULTS AND DISCUSSION
The main results are discussed critically according to the
main aims of the study; finding the best route to the nearby
healthcare facilities in the island, and identifying a suitable site
to build a new location of healthcare facility.
A. Database and Mapping of Healthcare Facilities
Distribution
This analysis creates a geodatabase for healthcare,
residential area, barrier, and road network. Fig. 1 shows the
distribution of healthcare facilities and residential areas. There
are 19 main and close healthcare facilities in total. One
hospital and 18 are clinics. There are two categories in these
healthcare facilities such as private and government. Out of 19,
3 are government healthcare and 16 are private healthcare
centres. The distribution also illustrates only one healthcare
facility is located in Pulau Indah which is Klinik Kesihatan
 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia
Pulau Indah and the rest are located at Port Klang and in the
Klang district. There are seven existing residential areas in
total. These residential areas are used to determine the nearest
and optimum healthcare facility and potential sites of a
proposed healthcare centre.
Fig 1. Database and Mapping of Healthcare Facilities Distribution
B. Optimum Accessibility to the Nearest Healthcare Facilities
This task is performed from all existing residential areas in
Pulau Indah to their one-way nearest healthcare facilities
(without travel barrier). As shown in Fig 2, seven routes are
generated from this analysis. Seven routes are going to Klinik
Kesihatan Pulau Indah which located at the middle of Pulau
Indah, while 1 route is going to Poliklinik and Surgeri
Semarak. Average travel distance from all residential areas to
go to nearest healthcare facilities is 3.4 kilometer. Average
travelling time is 3 minutes and the total travel cost is RM 0.77
for all seven routes.
Fig 2. Optimum Route to the Nearest Healthcare Facilities
258
It can be concluded that although the nearest healthcare
centre (such as Klinik Kesihatan Pulau Indah) is likely easy to
be reached by community for searching treatment, this limited
space clinic only offers a light and medium medical services.
Therefore, geospatial network analyses need to be conducted
for alternative route exploration and optimum clinic
accessibility.
C. Optimum Accessibility to Selected Healthcare Facility by
Selecting Alternative Routes
This technical analysis is conducted based on the real
scenario of the road in the study area (with travel barrier) to
identify which route is the best path to Hospital Tengku
Ampuan Rahimah (HTAR) when travelling in the peak time
(within 7am to 8am where heavy traffic is happened almost
every day). HTAR is a general hospital that is basically can
provide all types of medical services to publics. Mostly, every
morning got a lot of obstacle that can delay the travelling time
on the road (travel barrier). The result of this analysis is to
determine the best route in term of minimizing the travelling
time from selected residential area. Kampung Perigi Nenas is
selected as a case study in this experimental analysis to choose
an optimum way from two alternative routes to HTAR in the
peak time of working day:
1) Analysis 1 for Alternative Route 1: From Kampung
Perigi Nenas to Hospital Tengku Ampuan Rahimah.
Fig. 3 shows the road network analysis for route 1. Total
distance from Kampung Perigi Nenas to HTAR is 22 kilometer
and total time travel is 19 minutes.
HTAR,
Klang
Kampung
Perigi Nanas,
Pulau Indah
Fig. 3 Road Network Analysis for Route 1
2) Analysis 1 for Alternative Route 2: From Kampung
Perigi Nenas to Hospital Tengku Ampuan Rahimah. In Fig 4
indicates the road network analysis for route 2. Total distance
from Kampung Perigi Nenas to Hospital Tengku Ampuan
Rahimah is 29 kilometer and total time travel is 24 minutes
 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia

spatially to find the most suitable site of the proposed

healthcare facility in the study area as shown in Fig. 5.
HTAR,
Klang
This study has suggested that a healthcare site should be
located at near to the junction of Jalan Rahmat and Persiaran
Masjid Sultan Abdul Aziz with latitude 2°56'25.16"N and
longitude 101°19'24.44"E (Fig. 6). The location is relevant
place since it can cover evenly the residential areas and it is
closer to the existing government clinic to provide a better
health services to the communities.
Kampung
Perigi Nanas,
Pulau Indah

Fig 4. Road Network Analysis for Route 2

Table 1 illustrates the overall comparison of accessibility

parameters between route 1 and route 2 in terms of local
distance, cost, time travel, delay time, and time in a real
situation of the study area. It can be seen that route 2 is an
ideal alternative if someone wants to HTAR in an urgent
situation, but route 1 can be used as a main choice especially if
a driver select cost factor as a main priority. The cost in this
study is only considered the distance factor. The finding is Fig 5. A Proposed Healthcare Facility Site in Pulau Indah
important to assist the local communities to identify the ideal
route to arrive efficiently at HTAR and other healthcare
centres.

TABLE I
OPTIMUM ACCESSIBILITY BETWEEN ROUTE 1 AND ROUTE 2

Fig 6. A Proposed Healthcare Site as Displayed in Google Earth

D. Suitable sites to build a new healthcare facility in Pulau
Indah based on WHO criteria.
Based on guidelines from the District Health Facilities by
World Health Organization [15] here are certain criteria to
consider in order to locate new site for healthcare facility. The
first main criterion is to build new location such as healthcare
facilities need locate within 4 kilometer from residential areas.
Other than that the healthcare facilities distance not more than
200 meter from major road. In addition, the travel time must
be within 20 minutes from the current location to the nearest
healthcare facilities. All the criteria stated were analysed
V. CONCLUSION
The aims of the study are completed by recommending the
best route of healthcare accessibilities and proposing a new
site of hospital in Pulau Indah using geospatial approach and
certain spatial criteria. The results are not only significantly
used for local residents to define optimum facility
accessibilities, but also are essential to the national
government in efficiently planning the resources allocation of
healthcare delivery to the relevant destinations. However, the
findings can be added with other data and local criteria. Site

259
 2018 IEEE 14th International Colloquium on Signal Processing & its Applications (CSPA 2018), 9 -10 March 2018, Penang, Malaysia

visit observation in the study area should be conducted in

order to understand a clear picture of real situation and
problem that exist to the community and existing healthcare
facility accessibilities.

ACKNOWLEDGMENT
The authors thank to the State Health Department and
Department of Statistics of Selangor for providing data in this
study. Faculty of Architecture, Planning and Surveying, UiTM
Shah Alam is also appreciated for sponsoring the conference
fee registration.
REFERENCES
[1] A. Paez, R. Mercado, S. Farber, C. Morency and M. Roorda,
"Accessibility to health care facilities in Montreal Island: an application
of relative accessibility indicators from the perspective of senior and non-
senior residents", International Journal of Health Geographics, vol. 9, no.
1, p. 52, 2010.
[2] A. Kisch, "Aspects of Medical Care Administration: Specifying
Requirements for Health Care", Medical Care, vol. 12, no. 10, pp. 891-
892, 1974.
[3] A. Oliver, "Equity of access to health care: outlining the foundations for
action", Journal of Epidemiology & Community Health, vol. 58, no. 8,
pp. 655-658, 2004.
[4] A. Dos Anjos Luis and P. Cabral, "Geographic accessibility to primary
healthcare centers in Mozambique", International Journal for Equity in
Health, vol. 15, no. 1, 2016.
[5] D. Lunde, "Healthcare Management Gains Ground with GIS Services",
bcradesign, 2010. [Online]. Available:
http://bcradesign.com/sites/default/files/WAHealthcareNews_GIS%2BHe
althcare.pdf. [Accessed: 05- Feb- 2018].
[6] G. Higgs, "A Literature Review of the Use of GIS-Based Measures of
Access to Health Care Services", Health Services and Outcomes Research
Methodology, vol. 5, no. 2, pp. 119-139, 2004.
[7] I. Abbas, "Healthcare Facilities Mapping and Database Creation Using
GIS in Chikun Local Government, Kaduna State, Nigeria.", Global
Journal of human social science geography and environmental
geosciences ., 2012.
[8] I. R. Ejiagha, J. C. Ojiako and C. G. Eze, "Accessibility Analysis of
Healthcare Delivery System within Enugu Urban Area Using Geographic
Information System", Journal of Geographic Information System, vol. 04,
no. 04, pp. 312-321, 2012.
[9] J. Guagliardo, "Spatial accessibility of primary care: concepts, methods
and challenges", International journal of health geographics, 2004.
[10] M.T. Lokhman, A.R.A. Rasam, A.M.M. Noor, “Reforming Health Care
Facility Using Geographical Information System“, Control and System
Graduate Research Colloquium. pp. 267-270, 2012.
[11] P. Niewczyk and J. Lwebuga-Mukasa, "Using GIS to Investigate
Physical Access to Health Care Facilities", American Journal of
Epidemiology, vol. 163, no. 11, pp. S27-S27, 2006.
[12] R. Penchansky and J. Thomas, "The Concept of Access", Medical Care,
vol. 19, no. 2, pp. 127-140, 1981.
[13] S. Chen and E. Unal, "Spatial Accessibility of Health Care in Indiana",
Department of Agricultural Economics, Purdue University, vol. 07-07,
2007.
[14] X. Zhu, "A GIS-Based Multi-Criteria Analysis for Housing
Development in Singapore", in The national biennial Conference of the
Spatial Science Institute, 2005.
[15] World Health Organization [WHO]. “District Health Facilities:
Guidelines for Development and Operation”. Western Pacific Series No
22. [Online].
http://www.wpro.who.int/health_services/documents/district_health_fac
ilities_-_guidelines_for_development_and_operation.pdf [Accessed: 05-
Feb- 2018].

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