Assessing spatial accessibility of maternal healthcare in Cape Coast, Ghana

Ghana has seen encouraging improvements in reducing infant and maternal mortality rates over the past decades, but it remains a challenging issue. This is as a result of several factors, including transportation and socioeconomic factors, which affect maternal healthcare access, and eventually affect the healthcare outcomes. A clear understanding of the spatial accessibility patterns of healthcare services can help policymakers identify potential problems and make wise decisions to improve maternal healthcare in an area. In this study, we examined the spatial variability in access to maternal healthcare services across the Cape Coast Metropolitan area in Ghana. Incorporating transportation conditions and socioeconomic factors in our analysis, we implemented an augmented two-step floating catchment area (A2SFCA) method to investigate the spatial accessibility to maternal healthcare facilities in Cape Coast. The method uses different catchment area sizes to reflect the resource capacity of healthcare facilities and applies varying network-based distances to capture the reality that people may have different transportation modes available to them when visiting facilities due to their socioeconomic status. Accessibility analysis results reveal significant disparities in maternal healthcare access between population clusters of different socioeconomic status in the Cape Coast Metropolitan area. High socioeconomic areas enjoy better access to maternal healthcare, while low socioeconomic groups, especially those living at the peripheries, experience poor or no access. Consequently, these underserved areas have been identified as problematic areas for potential interventions. To enhance access to maternal healthcare, three potential solutions were proposed and evaluated: (1) adding one large hospital, (2) improving transport conditions, and (3) implementing small multiple healthcare facilities known as the Community-Based Health Planning and Services (CHPS) in Ghana. Evaluation results suggest the third potential solution as the most effective, ensuring that almost all communities in the region have access to maternal healthcare services. The study provides useful findings that will help assist healthcare policymakers, planners, and the government in improving maternal access across the region.