Comparative Analysis of Geographic Accessibility of Dentists, Physiotherapists and Family Physicians in an Urban Centre: A Case Study of Saskatoon, Canada.

BACKGROUND: The spatial arrangement of primary health care (PHC) services is influenced by many factors and varies across provider types. In Canada, unlike physician services, certain PHC services (i.e., dentistry, physiotherapy) are not fully funded under the health care system. As a result, one might expect the arrangement of these services to differ by neighbourhood, even in dense metropolitan areas. OBJECTIVE: This study examines the intra-urban variability of geographic access to dental (DS) and physiotherapy (PT) services in relation to family physician (FP) services in an urban area and identifies underserviced neighbourhoods. METHODS: Practice location information was gathered from publicly available and routinely updated provincial sources (physician, physiotherapy and dentistry regulatory colleges). A neighbourhood accessibility score for all 3 PHC services was calculated using a GIS-based, 3-step floating catchment area method. A set of parameters, such as catchment type (road network buffer), size (3 km radius) and census centroids (dissemination areas), was used. RESULTS: The overall access scores for FP, PT and DS services (based on the 281 FPs, 226 PTs, and 152 DSs) were 1.45 (SD 0.94), 1.18 (SD 0.81) and 0.79 (SD 0.53) providers/1000 population, respectively. Spatial comparison of the accessibility scores indicated a greater proportion of the Saskatoon population has lower access scores (< 0.5/1000 population) for both physiotherapy (n = 79 450) and dental (n = 101 270) services compared with family physician services (n = 64 420). Exploration of the relation between PHC service arrangement and key sociodemographic variables (e.g. low income, education levels) showed that a considerable proportion of those in each sociodemographic group has poor PT and DS access. CONCLUSION: This research has identified accessibility gaps and serves to inform the development of health policies focused on equitable distribution and funding of PHC services based on population health needs.

Condoms-one certainty in the fight against AIDS

Extra long, ribbed, studded, mint-flavoured, sheer fitting, lubricated, edible, glow in the dark the list is enticing. And if there is one certainty in the AIDS endemic, it is that a condom, if used correctly, can prevent HIV infection. In the Caribbean, however, the sexually active who are most at risk are failing to act sufficiently on the information. Among STD clinic attenders in Kingston, the prevalence of HIV infection has increased "tenfold" in the last four years. In a survey of 90 people with repeat STDs in the popular tourist area of Montego Bay, 10 percent tested HIV-positive. Also in Montego Bay, one in four of about 50 female prostitutes were found to have the AIDS virus. A survey of Kingston's female prostitutes found more than 10 percent were HIV-positive. These results had serious implications for people outside of the tested groups, because it was from these who were tested positive, that HIV spreads to the general population. The special education programmes targeted at the high-risk groups must be strengthened considerably, and access to condom needed to be improved considerably. In this connection, the National AIDS Programme was developing a strategy for widespread distribution of condoms through the private sector. Condom-use skills were being promoted because apparantly many people do not know how to use condoms correctly. Reports of condoms bursting were invariably, indicators of poor techniques and have little to do with sexual prowess (AU)