Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities

Abstract Background Spatial accessibility to healthcare is a critical factor in ensuring equitable health outcomes. While studies on a global, continental, and national level exist, our understanding of intra-urban differences, particularly between formal and informal areas within cities in sub-Saha...

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Main Authors: John Friesen, Stefanos Georganos, Jan Haas
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00746-5
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author John Friesen
Stefanos Georganos
Jan Haas
author_facet John Friesen
Stefanos Georganos
Jan Haas
author_sort John Friesen
collection DOAJ
description Abstract Background Spatial accessibility to healthcare is a critical factor in ensuring equitable health outcomes. While studies on a global, continental, and national level exist, our understanding of intra-urban differences, particularly between formal and informal areas within cities in sub-Saharan Africa, remains limited. Methods This study integrates openly available datasets on land use in 19 sub-Saharan cities, healthcare facilities in the region, and street networks from OpenStreetMap. Using these datasets, we calculate service areas around hospitals, considering travel times ranging from 1 to 120 minutes with walking as the mode of travel. The resulting service areas are then merged with population data from WorldPop, allowing us to assess the proportion of the population with specific travel times to healthcare facilities from informal and formal residential areas. Results Our analysis reveals that 33% of the urban population can reach hospitals within 15 minutes, 58% within 30 minutes, and 78% within 60 minutes. Importantly, for some cities, we observe significant differences between formal and informal areas, with informal areas experiencing a disadvantage in terms of spatial accessibility to healthcare facilities. The population in informal areas is particularly disadvantaged in medium-sized cities. Conclusions This study sheds light on the spatial accessibility of healthcare facilities in sub-Saharan African cities, emphasizing the need to consider intra-urban disparities, particularly in informal areas. The findings underscore the importance of targeted interventions and urban planning strategies to address these disparities and ensure that healthcare services are accessible to all segments of the urban population.
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spelling doaj-art-70da5807d73d42f687ae22ecdf7cb8442025-08-20T02:43:16ZengNature PortfolioCommunications Medicine2730-664X2025-02-015111210.1038/s43856-025-00746-5Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African citiesJohn Friesen0Stefanos Georganos1Jan Haas2Chair of Fluid Systems, Technical University of DarmstadtDepartment of Environmental and Life Sciences, Karlstad UniversityDepartment of Environmental and Life Sciences, Karlstad UniversityAbstract Background Spatial accessibility to healthcare is a critical factor in ensuring equitable health outcomes. While studies on a global, continental, and national level exist, our understanding of intra-urban differences, particularly between formal and informal areas within cities in sub-Saharan Africa, remains limited. Methods This study integrates openly available datasets on land use in 19 sub-Saharan cities, healthcare facilities in the region, and street networks from OpenStreetMap. Using these datasets, we calculate service areas around hospitals, considering travel times ranging from 1 to 120 minutes with walking as the mode of travel. The resulting service areas are then merged with population data from WorldPop, allowing us to assess the proportion of the population with specific travel times to healthcare facilities from informal and formal residential areas. Results Our analysis reveals that 33% of the urban population can reach hospitals within 15 minutes, 58% within 30 minutes, and 78% within 60 minutes. Importantly, for some cities, we observe significant differences between formal and informal areas, with informal areas experiencing a disadvantage in terms of spatial accessibility to healthcare facilities. The population in informal areas is particularly disadvantaged in medium-sized cities. Conclusions This study sheds light on the spatial accessibility of healthcare facilities in sub-Saharan African cities, emphasizing the need to consider intra-urban disparities, particularly in informal areas. The findings underscore the importance of targeted interventions and urban planning strategies to address these disparities and ensure that healthcare services are accessible to all segments of the urban population.https://doi.org/10.1038/s43856-025-00746-5
spellingShingle John Friesen
Stefanos Georganos
Jan Haas
Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
Communications Medicine
title Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
title_full Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
title_fullStr Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
title_full_unstemmed Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
title_short Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
title_sort differences in walking access to healthcare facilities between formal and informal areas in 19 sub saharan african cities
url https://doi.org/10.1038/s43856-025-00746-5
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