ABSTRACT
Low- and middle-income countries are significantly impacted by the global scarcity of medical imaging services. Medical imaging is an essential component for diagnosis and guided treatment, which is needed to meet the current challenges of increasing chronic diseases and preparedness for acute-care response. We present some key themes essential for improving global health equity, which were discussed at the 2023 RAD-AID Conference on International Radiology and Global Health. They include (1) capacity building, (2) artificial intelligence, (3) community-based patient navigation, (4) organizational design for multidisciplinary global health strategy, (5) implementation science, and (6) innovation. Although not exhaustive, these themes should be considered influential as we guide and expand global health radiology programs in low- and middle-income countries in the coming years.
ABSTRACT
PURPOSE: The purpose of this study was to design, develop, and test geographic information systems (GIS) analytic methods for quantifying and characterizing catchment populations across all sites served by a radiology global health organization. METHODS: The analysis included populations served by 78 low-resource medical facilities in 32 countries partnered with radiology nonprofit organization, RAD-AID International. Three constraints were used to approximate patient catchment areas: (1) 1-hour driving time, (2) 1-hour walking time, and (3) 10-mile circular radius. GIS calculated populations within each constraint using publicly available geospatial input databases, including a global digital elevation model, population and land cover data, and road locations from OpenStreetMap. Demographic and health data from the World Health Organization were incorporated to provide further characteristics of covered populations. RESULTS: The total populations served by all RAD-AID sites as measured by driving time, walking time, and 10-mile radius were 189,241,193 (47.8% female), 26,190,117 (48.7% female), and 110,884,095 (48.1% female), respectively. For individual locations, median population within 1-hour driving time was 1,795,977 (range: 8,742-30,630,800), with an average life expectancy of 68.4 ± 5.8 years. Median child mortality before age 5 was 3.8% (range: 0.9%-8.3%), and median prevalence of human immunodeficiency virus infection was 3.1% (range: 0.7%-10.9%). CONCLUSION: In this study, GIS provided a robust multisite analysis for estimating the potential global population reached by an international radiology outreach organization with targeted individual site measurements. Given heightened needs to accurately characterize global outreach populations, this GIS-based approach may be useful for analysis, outreach planning, and resource allocation among global health organizations.
Subject(s)
Geographic Information Systems , Radiology , Child , Child, Preschool , Female , Global Health , Humans , Male , Radiography , WalkingABSTRACT
BACKGROUND: Communities throughout northern Canada face significant health care disparities including decreased access to radiology. A medical hybrid airship is under development which aims to serve remote populations, requiring strategic outreach planning. This study aims to use geographic information systems (GIS) to identify (1) high risk and medically underserved patient populations in northern Canada and (2) potential landing sites for a medical airship to allow for mobile delivery of radiology services. METHODS: The northern region of Canada extending from the Rocky Mountains to the Atlantic Ocean was analyzed using multi-variable, multi-weighted GIS modeling. Based on population distance from hospitals (50% weight), health centers (eg, clinic; 30% weight), remote communities (not connected to electric grid; 10% weight), and roads (10% weight), individuals were stratified into one of five health care accessibility index (HAI) categories (ranging from very low to very high severity). HAI (80% weight) was combined with population density (20%) to create a health care access severity index (HASI). Topographic and land cover data were used to identify suitable landing sites for the medical airship. A coordinate data set was made from georeferenced health care facilities, and infrastructure data was obtained from OpenStreetMap. RESULTS: GIS analyzed 815 772 Canadians. Of this population, 522 094 (64%) were found to live ≥60 km from a hospital, 326 309 (40%) were ≥45 km from the nearest health center, 65 262 (8%) were within 30 km of a remote community, and 57 104 (7%) lived ≥1 km from the nearest road. Combined, the HASI identified 44% of the population as having decreased access to care (high or very high severity). Lastly, 27.5% of land analyzed was found to be suitable for airship operations. CONCLUSIONS: GIS identified medically underserved populations in northern Canada who may benefit from mobile radiology services. These techniques may help to guide future global health outreach efforts.
