Geographical accessibility of cancer hospital using geospatial technology in Bagmati province, Nepal

Background: Ensuring convenient access to cancer screening, diagnosis, and treatment is essential for mitigating and preventing the disease. Geographical accessibility plays a crucial role in cancer mitigation and healthcare planning, particularly in low-income countries such as Nepal. A spatial perspective is crucial for improving cancer mitigation planning and evidence-based policy formulation. This study examined the spatial accessibility and population coverage at the municipal level in Bagmati province, Nepal. Method: This study utilized spatial data, including LULC, DEM, OSM road networks, population distribution, and location of cancer hospitals, to calculate three different scenarios for reaching these hospitals. Based on that, a raster surface of travel time between residences and cancer hospitals was developed. We incorporated terrain, physical barriers, travel modes, speeds, and topography through various land-cover classes. Accordingly, underserved populations and zonal statistics were assessed using an interactive modeling approach to determine the spatial relationship between population, travel time, and zonal boundaries. Results: The motorized travel scenario exhibited the highest spatial accessibility, followed by the bicycling and walking scenarios. It varied significantly across the three scenarios. The motorized scenario has the highest accessibility, with 72.57% of people covered within a 30-min travel time. Motorized scenario has a maximum people coverage of 96.78% within a 360-min travel time. Kathmandu Valley and Chitawan urban areas showed higher accessibility across all scenarios, attributed to easy road networks. Rural and mountainous regions in the middle hills of the northern and eastern parts have low accessibility, attributed to steep slopes, scattered settlements, and sparse infrastructure. Conclusion: The findings demonstrate significant spatial disparities across various travel scenarios, underscoring the need for spatially informed health planning and policy development. These insights provide a foundation for addressing problems and enhancing cancer care delivery in Nepal using spatial techniques.