Situation analysis of healthcare service delivery using geographically weighted regression: (A case study of Sironko District, Eastern Uganda)

Abstract

Geography plays an important role in planning and allocation of healthcare resources for an effective and efficient health system. Lack of statistical information analyzed using geostatistical tools then becomes a major bottleneck to proper planning and policy formulation in healthcare delivery. This study sought to compare existing health staffing, funding and medical supplies data given minimal national healthcare package, spatially explore the relationship between health service utilization and gaps in resource allocation, and to develop propositions to support the health policy. Facility survey and secondary data collection from the District Health Office and the Ministry of Health were utilized. Geographically Weighted Regression was used to spatially explore the relationships between Out-patient department attendance and gaps in health funding, staffing and stock-out days for essential drugs in health facilities. Global Moran’s I test was performed on the standard residuals to statistically test for their randomness. The analysis yielded local parameter estimates which were mapped to reveal the spatial variation of the relationships. There was strong influence of facility allocation gap in the North West diminishing towards South East, Strong negative influence of the staffing gap in the South West diminishing eastwards, and High influence of Stock-Out days in the South compared to the South West. Basing on the observations, the study proposed increased health vote while revising allocation based more on need other than solely on budgetary allocation of funds, increased staffing and providence of incentives for disadvantaged areas, and monitoring of drug supply and dispensing at health centres.