Geographical access to health care facility among residents of Kalutara district in Sri Lanka- a cross sectional study

Achieving universal health equity remains a global challenge. The World Health Organization advocates for universal health coverage to ensure accessible, quality healthcare for all, regardless of financial status. Geographic Information System (GIS) technology has been instrumental in assessing healthcare accessibility, revealing gaps and informing policy decisions. This health-system study aimed at mapping and analyzing geospatial distribution and accessibility of Western healthcare facilities in Kalutara District; explicitly comparing government vs. private services and the contribution of general practitioners (GPs). A descriptive cross-sectional study was conducted from May 2019 to October 2019. The study geospatially mapped all healthcare institutions practicing Western medicine within Kalutara district and a 5 km buffer zone beyond its boundaries. Data were collected using Epicollect5, a mobile application, ensuring accuracy within 10–15 m. Variables included geospatial information and service availability. Data analysis was performed using ArcGIS 10.3, assessing coverage within buffer zones of 2 km to 4 km radii around each healthcare institution. General practitioners covered 87.8% and 98.1% of the population within areas of 2 km and 4 km radii. All government institutions covered 21.8% and 67.6% of 2 km and 4 km radial buffer areas, while the coverage of private hospitals amounted to 3% and 8.8% respectively (i.e. within 2 km and 4 km). Including general practitioners with government and private hospitals, total population coverage incremented to 64.1% within 2 km and 90.0% within 4 km. Majority of government hospitals and all private hospitals had inpatient care and 24 × 7 care. Blood banks were available only in 83.3% of specialized government hospitals. Of general practices, 10.6% had 24 × 7 care and 37.5% of private hospitals had Intensive Care Unit (ICU) facilities. The study highlighted the significant role of general practitioners in providing accessible healthcare, especially after routine working hours. GP settings contributed mainly in ensuring geographical access to healthcare. Hence, GP services need to be considered in all attempts of improving healthcare service delivery.