Spatial access to health care: a case study on community health centers in Asmat District, Papua, Indonesia

In recent decades, access to primary health care has become a crucial issue for health policy planners and researchers. One of the fundamental problems is inequitable access to health care due to imbalanced resource distributions between health care providers and population location. Accordingly, this study aims to examine the spatial access to Community Health Centers (CHC) in the Asmat district, one of the most isolated regions in Papua, Indonesia. We conducted the study using a two-step floating catchment area (2SFCA) method to quantify accessibility value to primary health care of each village in the district of Asmat. By taking five distance thresholds ranging from 5 to 25 km with an increment of 5 km, the results indicate that distance has a varying impact on each village. For example, within a 5-km distance threshold, 74% of villages have a zero score or have no access to CHCs, 22% have a score < 100, while only 4% of villages have a score > 100 or meet the minimum score recommended by World Health Organization (WHO). Two major related factors of these geographic disparities are the unequal distribution of CHCs and the high population dispersion. As an attempt to provide equal access to health care services, these results suggest that spatial access should be conscientiously considered by health planners and policy makers.