Obstetrical interventions and health centre coverage: a spatial analysis of routine data for evaluation

In this paper a spatial analysis of routine utilization data is used as a cheap and sensitive contribution to the overall evaluation of the health care delivery system. Routine data on major surgical interventions for complicated labour in a rural area in Eastern Zaire are analysed. Distance decay of intervention rates is marked for the rural population, but less so for areas covered by the health centre network. A coefficient of localization is used to assess the inter-area variation in intervention rates. It can be shown that differences between areas tend to diminish over the years.