Enhancing geographical access to cardiovascular disease healthcare services in Lagos State, Nigeria

Abstract

Cardiovascular diseases (CVDs) are the leading cause of global mortality, and three-quarters of the world’s deaths from CVDs occur in low- and middle-income countries. Improving spatial access to care facilities is a way of reducing the disease burden through early detection and treatment. Determining the number of facilities to provide and the locations in order to improve accessibility is central to healthcare facility planning. The maximal covering location problem (MCLP) was used in the identification and determination of where to place additional CVD treatment facilities in Lagos State for better accessibility. The primary objective of this study was to optimize the placement of CVD facilities to maximize coverage for both patients and non-patients alike. The optimization model utilized data on the population of Lagos State, the locations of CVD patients, the location of existing CVD care facilities, and the locations of general hospitals (GHs) within the state. The MCLP implementation was carried out using the maxcovr. The results of the models indicated that the addition of two facilities at the Isolo and Ile-Epo GHs would enhance CVD patient coverage from 70 to 87.4%, reducing the average travel distance from 9,038 to 6,466 m. Similarly, the introduction of two facilities at the Ikorodu and Ajegunle GHs improved population coverage from 40.3 to 70.8%, reducing the average travel distance of 18,788 m by over 5,000 m. These findings are expected to offer valuable insights for public health decision-makers who face the challenge of prioritizing limited budgets.

Keywords

• accessibility
• cardiovascular diseases
• maximal covering location problem
• facility location
• lagos state