Spatial analysis of public health facilities in Riyadh Governorate, Saudi Arabia: a GIS-based study to assess geographic variations of service provision and accessibility

Much attention has been given to address public health policy in Saudi Arabia, particularly for the management, quality, and coverage issues. However, assessment of spatial patterns, distribution, and provision of public health services has been neglected. This paper analyzes the availability and accessibility of public health facilities across Riyadh Governorate, Saudi Arabia at the subnational level. Spatial and attribute data of public health facilities potentially have been analyzed using GIS to produce accurate measure of accessibility. The spatial pattern of service distribution was examined using average nearest neighbor. Distances from demand points (populations) to providers (facilities) were calculated for each district using near analysis. In addition, the ratios of public health facility to population were calculated to identify underserved and overserved areas. The findings clearly indicate that the spatial pattern of the distribution of public health facilities was significantly clustered (p value < 0.001) with Z-score of −10.9. Several districts within the central parts of the governorate were identified as having a higher density of facilities, while most of districts that are located in the marginal parts exhibit very low density of health facilities. Overall, there was a considerable variation in the average distance from district centroids to health facilities. Substantially, less than half of the population (45.4%) living in 61 districts has access to public health facility within less than 1-km distance. In contrast, the greatest increase in distances was observed for 6% of population living in 38 districts. People that live in such districts need to travel long distances for public health care. The output of this analysis can assist policy-makers and authorities of Riyadh Governorate in planning public health delivery.