E.1    
 
Location and accessibility of health centres    
 

Efficient delivery of health services is crucial not only for the treatment of the sick and ill and injured but also for alleviating poverty, securing livelihoods, and enabling economic development in general. Hence, it is important to understand what fraction of the population has access to health services, and of what quality, and in what time.

In the National Population and Housing Census of 2005 heads of villages were asked if their village had a clinic or health centre. No additional information was collected on the quality or the state of such a health centre; however the mere number and location of the villages with health centres shown in Map E.1 provides some interesting insights.  Of a total of 10,552 villages only 791, only 7.5%, reported the presence of a health centre.
In order to enhance this information, the travel time to and from each health centre was calculated for the whole of the Lao PDR. This calculation was based on a model of accessibility, which is described in more detail in Maps A.5 and A.6. The results show regions of the country with different travel times to the nearest health centre, ranging from less than 1 hour (coloured green) to more than 10 hours (coloured red).

The spatial patterns show the green easily accessible regions of the country which reflect the transport infrastructure, but there are large areas of the country which are completely isolated from health service delivery. Thus it is interesting to investigate the number of villages situated within a particular range of accessibility. This allows the calculation of the number of people who have, or do not have, access to a health centre. The table below presents the results and shows the percentages of the villages and the population in the different classes of accessibility to health centres:

Accessibility
class
Percentage of
villages
Percentage of
population
Cumulative
percentage of
population
0 to 0.5 h
61.5
74.6
74.6
0.5 to 1 h
11.9
9.2
83.8
1 to 2 h
9.8
6.6
90.4
2 to 4 h
9.6
5.6
96.0
4 to 7 h
5.3
3.0
9.0
More than 7 h
2.2
1.0
100
Table 5: Accessibility of villages and people to the nearest health centres by different classes of travel time






















This table shows that despite the inaccessibility of many regions in the Lao PDR, many villages and an even higher percentage of the people are quite close to a village with a health centre. Even if there are only 791 health centres in the country, 84% of the population are still able to reach a health centre within one hour, and over 90% within a maximum of 2 hours. From these figures we can conclude that even if some regions are urgently in need of further health infrastructure, priority should be given to maintaining or improving the quality of the existing health service centres. The number of people depending on each health centre could easily be calculated to prioritise the villages that should receive such support.

 

 


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