A composed index of critical accessibility (CICA) to healthcare services in a traditional African City

While empirical works that analyse rural–urban differentials in accessibility to health services are common in the developing countries, systematic studies focusing on intra-urban variations in accessibility to overall healthcare resources remain scant. Yet, many urban dwellers especially in the Sub-Saharan Africa have to travel long distances within the urban space to access basic health services. This study employs composed index of critical accessibility (CICA) to analyse differentials in access to health resources in Ibadan, a traditional African City. Data on healthcare centre location, ownership, doctors’ population were collected through field survey while spatial data on the administrative units and populated places were obtained from archival sources. Also, data on road networks was collected. Results show that the distribution of health facilities across local administrative units varies. In terms health facilities, Ibadan South West has 26 (36 %) of the total number while Ibadan South east has only 7 (9.8 %). The Doctor-Population Ratio also exhibits similar variations as Ibadan North has 20.5 as against 2.2, 1.9 and 0.3 for Ibadan SW, Ibadan NW and Ibadan NE respectively. The CICA analysis shows that 228,938 inhabitants are in high risk of negative accessibility while 49,234 are faced with condition of low risk of negative accessibility, which implies that a significant proportion of the population still finds it difficult to access basic health services as and when needed. The variations in the distribution of this deprived population are also noteworthy as the largest proportion of this group was localized in Ibadan NW. This has grave implication for the health and wellbeing of the population and raises once again the question of spatial equity in the delivery of urban public service. Curiously, these differences in the level of accessibility cut across administrative boundaries which brings to the fore the role of jurisdictional partitioning in ensuring equity in the delivery of urban public services. This opens a vista of research opportunity into the role jurisdictional partitioning in service provision in the urban centres.