Analysing the primacy of distance in the utilization of health services in the Ahafo-Ano South district, Ghana

Int J Health Plann Manage. 2003 Oct-Dec;18(4):293-311. doi: 10.1002/hpm.729.


Although the distance factor has been identified as key in the utilization of health services in rural areas of developing countries, it has been analysed without recourse to related factors of travel time and transport cost. Also, the influence of distance on vulnerable groups in utilization has not been an object of survey by researchers. This paper addresses the impact of distance on utilization, and how distance compares with travel time and transport cost that are related to it in the utilization of health services in the Ahafo-Ano South (rural) district in Ghana. The study, a cross-sectional survey, also identifies the position of distance among other important factors of utilization. A sample of 400, drawn through systematic random technique, was used for the survey. Data were analysed using the regression model and some graphic techniques. The main instruments used in data collection were formal (face-by-face) interview and a questionnaire. The survey finds that distance is the most important factor that influences the utilization of health services in the Ahafo-Ano South district. Other key factors are income, service cost and education. The effect of travel time on utilization reflects that of distance and utilization. Recommendations to reduce distance coverage, improve formal education and reduce poverty have been made.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Cross-Sectional Studies
  • Developing Countries
  • Family Characteristics
  • Female
  • Ghana
  • Health Care Surveys
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Hospitals, Rural / statistics & numerical data*
  • Humans
  • Income
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Rural Health Services / statistics & numerical data*
  • Transportation / economics*
  • Transportation / statistics & numerical data