DEPARTMENT OF NATURAL RESOURCE AND ENVIRONMENTAL

STUDIES

PROGRAM: GEOGRAPHIAL INFORMATION SCIENCE

SENIOR REASERCH PROJECT ON: Assessment of distribution of

health facilities using GIs techniques in the case of
aletawondoworeda, sidama zone

SUBMITED BY: TILAHUN ASCHALEW

SUBMITED TO: ashenafi burka

MAY, 25, 2015

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WONDO GENET ETHIOPI
Lists
BACKGROUND
1 .INTRODACTION
2 .STATEMENET OF the PROBLEM
3. OBJECTIVE
3.1 GENERALE Objective
3.2 Specific objective
4. Literature review
4.1 the analysis of discrete
entities in space
4.2 modeling the accessibility
of health facilities use gis
4.3 Gis health are distribution
4.4 what is health gis ?
4.5 spatial distribution of select
child health characteristic in
Boston, mass achusetts
5 .METHODS AND MATERIALS
USED
5.1Description of the study area
5.1.1Description of the study
area
5.1.2population
5.1.3 Topography
5.1.4. Climate
5.1.5 Temperature and Rainfall
6 Materials will be used
7 Data collection techniques
8 Data analysis
9 Flow chart
10 Activity plan
11 Budjet break down
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 12 Reference 19

1. BACKGROUND
I. Introduction
The world health organization (WHO) defined health in its broader
sense in 1946 as “a state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity ”.the term
“healthy” is also widely used in the context of many types of non-living
organization and their impacts for the benefits of humans. So, health is
needed for the world (the world health organization 1946)In developing
countries such as Africa the health facility is available, accessibility
becomes the problem. This contributes to significant delays in accessing
health care. In most countries roads are inaccessible and transportation
system is chaotic. Thus when a person takes a decision to seek medical
attention, it may take days to reach health care facility. (Mefin,
N.2003).GIS provides useful techniques regarding capturing,
maintaining and analyzing of spatial data.The role of monitoring
and evaluation is that of coordinating all activities in order to create
an efficient and aesthetically pleasing physical environment for all
forms of human activities in order to create an environment which
has quality of acceptable standards for health and efficiency, and
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which enable individual families and communities to live and work
in asatisfactory manner (Vagale, 1971). Three of the MDGs are
related to health: reducing child mortality, improving maternal health
and halting the spread of Acquired Himan Immunodeficiency
Sunderom (HIV/AIDS), malaria and other communicable diseases The
emphasis given to health among the MDGs indicates to its central role
in reaching the MDGs specifically those related to eduction and
poverty.
There has been encouraging progress in recent years towards
improving some basic aspects of life in Ethiopia. Since 1996 the rate of
malnutrition has fallen by 20%, the share of the population with
access to clean water has risen to 38% and according to the studies
there has been a steady decline in the reported incidence of illness.
Nonetheless, human development indicators in Ethiopia still remain
at low levels as compared to countries around the world. More than
15% of children die before their fifth birthday; 47% of children are
malnourished in some form or another. With under five mortality rate
of 140 (per 1000 live births) Ethiopian children are among the least
favored. The health care facilities under the MDGs project would be
made available to an extent, especially the basic amenities of life
such as safe drinking water and hygienic environment.In view of the
above, the study therefore identified and health care facilities of the
MDG available in aletawondo and areas with the view to monitor
health care delivery in the study area. National Planning
Commission (2006) stated that the rural populace in developing
countries has been suffering from different kinds of deprivation yet;
they constitute the bulk of the population. For effective and
functional health caredelivery, spatial data is required on location
and changes taking place within and around the communities to be

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able to carry out planningGISwas used to identify environmental
indicators and. Hence, there is a need to introduce scientific
mapping technique that would reveal the spatial location of health
facilities such as the GIS-based application shown in a study of
access to health care facilities when geographic information was
used to link data from a population-based survey with an
independently sampled health facility survey (Hong,2006). Onsi,
(2004) also used remote sensing and GIS technology to identify
health facilities and delineate associated health risks, demonstrated
the practical and successful application of remote sensing and GIS
in assisting decision-making for health and development and the
effectiveness of map making.Improving the public health services that
are available to all citizens should be pursued as one of the main
purpose of strategy of health in Aletawondo town. In order to meet
this objective the health have to plan how to spatially distribute the
health facilities in Aletawondo town equally, and making them easily
accessible to the public.(www.ijstr.org/spatialdistribution of primary-
health are centers)

2. STATEMENT OF THE PROBLEM

Accessibility to health facilities has a strong influence on people
earning capacity and it is fundamental to people’s ability to enjoy
and appreciate other aspect of life. Regarded accessibility to health

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facilities for an individuals in spatial perspective and that the physical
accessibility of the house hold member to health facilities is of
considerable importance, but it is ,however, constrained by distance.
This is due to lack of tangible and reliable planning information and
lack of knowledge of tools like GIS which will help the planners in
resource allocation and decision making process. As a result, the
people of Aletawondo town are facing challenges to access the
health facilities during emergency and also subjected to extra costs of
transportation. Therefore, this study will focus on assessing the
distribution and accessibility of health centers so as to enhance an
improved health service in the area.

3 OBJECTIVES
2.1 GENERAL OBJECTIVE

• To assess the geographic distribution of health facilities

inAletawondoworeda.

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 2.2 SPECIFIC OBJECTIVES

• To identify an inventory of all the public and private health

facilities in Aletawondoworeda.
• To model the accessibility to health facilities.
• To map the public and private health facilities in
aletawondoworeda
• To show the special pattern of health facility distribution
• To prepare accessibility map of health facilities in
aletawondoworeda

4 LITERATURE REVIEW
4.1The analysis of discrete entities in space
Having gone to the trouble of collecting data and building a
spatial database, the next issue is how to use these data to provide
information to answer questions about the real world. This
involves a wide range of methods of data manipulation from
simple data retrieval and display to the creation and application

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of complex models for the analysis and comparisons of different
planning scenarios. (A.mc DONNEL, 1998)
4.2 Modeling the accessibility of health facilities using GIS
Historically there has been a problem in Ethiopian where medical
facilities, which are often located in the large metropolitan cities,
were not actually best serving the populations who most
desperately needed them. Where people live affects their health,
nutrition, and access to health care services. To promote a better
understanding of these issues, MEASURE DHS has routinely
collected geographic information in nearly all surveyed countries
since 1996. Using GIS, researchers can link DHS data with
routine health data, health facility locations, land use, local
infrastructure, and environmental conditions (the MEASURE
DHS (Demographic and Health Surveys) project, implemented by
Macro International Inc. and funded by USAID, 1984)

4.3 GIS and health care distribution

Military strategists need maps, and so do health care planners
for whom geographic location or the spatial distribution of
resources and people are equally important. Spatial analysis is
indispensable to evaluating patient access to managed care
Provider networks or modeling demand for services based on the
analysis of health and demographic characteristics of patients.
(Professor Zvia Segal Naphtali, 2005).
4.4 What is Health GIS?
A Health Geographic Information System (GIS) is an innovative
framework for accessing, integrating, visualizing and utilizing
information that can inform decisions affecting child and
maternal health care. Health GIS analyses incorporate statistical,
demographic, health facility, and spatial data from health
information systems, surveillance, surveys and maps. Customized
queries and analyses can focus on geographic reference points of
interest—such as health facilities, towns, or administrative
districts, or a specific cohort of interest—such as children under

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 the age of five. For example, a GIS analytical approach can reveal
relationships and trends that might not be evident when the data
is viewed in tabular format. Epidemiological data can be mapped,
allowing users to detect and explore any potential spatial patterns
of disease outbreaks. Gaps in health care access can be quickly
identified by locating populations that do not have access to
health facilities located within a Querying a Health GIS to locate
and map populated reasonable travel distance (see left).(Mark
Landry1, Cheri Rassas1, Alan Fairbank1, Nancy Pielemeier1, &
Ahmed Attieg2
APHA Conference, November 6 - 10, 2004, Washington, D.C)

4.5 Spatial Distribution of Select Child Health

Characteristics in Boston, Massachusetts
This section presents a series of GIS-generated maps illustrating
the spatial dimensions of a range of health characteristics. The
data-generated maps present data by census tracts and
neighborhoods. In the first section below, Map I shows the
number of Asthma incidents in Boston as reported in 2009.
In order to show how this information might be related to race
and ethnicity, Maps II, III, and IV illustrate the concentrations of
the Black, Latino, and Asian populations in Boston by census
tracts and based on 2006 estimates. The dots do not represent the
location of individuals but rather a pattern of spatial relations
indicating density.(Review of Select Findings in the National
Health Interview Survey (2009)James Jennings, PhD Tufts
University.(National Health Interview Survey ,2009)

5.0 METHODS AND MATERIALS USED

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5.1 Description of the study area
5.1.1 Location
The study area entirely lies within the Sidama Zone, in the Southern
Nations, Nationalities and Regional state. Astronomically, the area
under consideration is located between 60 15΄ and 60 45΄N latitude,
and between 38 15΄ and 38 45΄E longitude. In relative terms, it is
bordered Dale Woreda in the North, DarraWoreda in the South,
Bursa Woreda in the West, ChukkoWoreda in the East,
HullaWoreda in the South west (Map 1 and 2). The study area spans
over a total area of about 567.03 square kilometer
5.1.2population
Based on the 2007 Census conducted by the CSA, this woreda has a
total population of 188,976, of whom 96,640 are men and 92,336
women; 22,093 or 11.69% of its population are urban dwellers. The
majority of the inhabitants were Protestants, with 72.78% of the
population reporting that belief, 7.38% practiced Ethiopian Orthodox
Christianity, 3.91% were Muslim, 3.65% were Catholic, and 3.54%
observed traditional religions.
5.1.3 Topography
The nature of topography of a particular geographic entity has multi
dimensional implications up on the development of physical
infrastructure, human way of life and the type of flora and fauna
exists. For that matter the topographic setting of the area under
study was dealt with. Aletawondoworeda is by large falls within the
southeastern highlands and in fact yet small portion lies within the
rift valley physiographic regions. The map obtained from Sidama
Zone Planning and Economic Development Department (SZPEDD,
2001) reveals that the elevation of the study area ranges between
1001 and 2,500 meters above sea level. Consequently the elevation
difference in the study area is about 2,000 meters that demonstrate

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the existence of variegated agro climatic zones. This also creates the
opportunity to have a varied flora and fauna. On the other side,
however, the ruggedness of the terrain has a negative impact on the
cost incurred for the development undertaking infrastructure and
mechanized farming.

5.1.4. Climate
Climate is one of the elements of the physical environment which has
a pronounced impact on settlement pattern, human way of life, the
type of the soil, flora and fauna existed and/or developed so forth.
Among different climatic elements temperature and rainfall have a
considerable impact in such an agrarian country like Ethiopia and
more actually in the area under study.
5.1.5 Temperature and Rainfall
The temperature distribution of the study area is mainly a reflection
of elevation. Accordingly, the study area comprises varied thermal
zones ranging from ‘kolla’ (Tropical) to ‘Dega’. According to Daniel,
1977, the study area falls within the rain fall regime IA. This rain fall
regime is characterized by one of the rainy season, i.e. the rainy
months from March to October. The Woreda receive
a mean annual rainfall varying from 801-1000mm in the western
parts to 1401-1600mm in the central and northern parts.

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6 Materials will be used

No Materials will Function

be used
1 Gps (garmin) For filed data collection

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2 Garmin soft for gps data down
were loading
3 Computer hard For data a management
were and soft and analysis
were Statistical analysis
(ArcGis9.3)
4 Stationeries To write field data and
other attribute
information
5 Satellite image For digitization of the
and land sat roads and to extract the
TM+ selected area of study

7 Data collection techniques

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The primary data will be collected from filed survey and gps will be
used to pinpoint the location of existing health
Care facilities and other necessary secondary data will be obtained
from the Aletawondo town health offices and
From each health facilities.

No Data type Resolution Year Source

/ scale
GCP (gps data ) 30 point in no
1 2013 Field
survey
Land sat TM+
2 85*85 2010 Glcf

8 Data analysis
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 The data analysis for this study will be use different techniques .
ArcGIS software will be used to analyze The data for example the
pattern analysis tool (nearest neighborhood, spatial auto
correlation and hot spot analysis, the inferential statistical tool)
will be applied in analyzing the data in this research is the
“nearest neighbors tool”. This techniques will be used to establish
the distribution pattern of the health care facilities in the study
area.
Nearest neighborhood analysis is the method of exploring pattern in
the locational data by comparing mean distance (do) of the
phenomena in question to the same expectedmean distance
(de)usually under a random distribution. And buffering will be
used to identify those
health facilities accessible to the public within certain distance.

9 Flow chart
Ethio_gis Keble lebel
Gps data _Road shape file population
_Woreda
boundaries

GDBMS

NNA BUFFER
ANALYSIS

DISTRIBUTI ACCESSA
ON BILITY OF
PATTERN MAP
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10 Activity plan

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11 Budjet break down
N List of item Quantit purpos Unit total
y e cost(bir
r)
1 Note book 2 2*20 40
2 Pen 2 2*5 10
3 Flash disk 2 2*120 240
4 CD_RW 2 2*25 50
5 Bider 2 2*25 50
6 Ruler 2 2*5 10
7 Gps battery 4 4*20 80
8 Hand held 2 2*_ _
Gps
9 transportation 2 2*500 100

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 0
1 Food&dormita 2 2*500 100
ry 0
1 Data - - -
-land sat
TM+
-GCP
1 Total 248
0

12 Reference
1. Hong, R (2006): Family planningservices quality
2. National Planning Commission (2006): Nigeria 2006Millennium
Development Goals’ Report, Abuja: Government of the Federal
Republic of Nigeria.
3. Vagale, G (1971): Introduction to Geographic
Information Systems,
4. Spatial analysis of health facilities
(www.proceedings.esr.com/library/user conf/proc11/paper/3271-
63.pdf)

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5.Spatial distribution of primary health
arecenters(www.ijstr.org/.../spatial-distribution-of primary health
care centers... )
6.Spatial analysis of health
facilities(www.proceedings.esr.com/library/user
conf/proc11/paper/3271-63.pdf)
7.Distribution pattern of health facilities
(www.ajol.info/index.php/ejesm/article/download/159839148113)
- Adeyemo, D.O. (2005). Local Government and Health Care delivery in
Nigeria: A Case study. Journal of Human Ecology, 2, 149 – 160.

- Adejuyigbe, O. (1973). Location of Social Science Centre in Western

Nigeria, the case of Medical Facilities , Man and Society, 1, 115-142.
-Aregbeyan, J. B. O. (1992). Healthcare service utilization in Nigeria
Rural Communities
- Bagheri, N., Benwell, G.L., Holt, A. (2005). Measuring spatial
accessibility to primary healthcare. Being a paper presented at SIRC
2005-17TH Annual Colloquium of the spatial information Research
Centre University of Otago, Dunedin, New Zealand, Nov 24th-25th,
2005.

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