INTRODUCTION

1.1 BACKGROUND TO THE STUDY

Health is a state of complete physical, mental and social wellbeing and not merely the

absence of disease or infirmity (Jiva, 2013). Many people do not realize the importance of

good health, and even if they do, they may still disregard it. Sound health is a fundamental

requirement for living a socially and economically productive life. Poor health inflicts great

hardships on households, including debilitation, substantial monetary expenditures, loss of

labor and sometimes death (Titus, Adebisola and Adeniji, 2015). The necessity of good

health is not limited to a particular set of people, bringing good health care systems and

information closer to the people is important.

A health system is referred to as the organization of people, institutions and resources to

deliver health care services that will meet the health needs of a target population. It is also

the prevention, treatment of illness and the preservation of mental and physical well-being

through the services offered by the medical and allied health professional. In another,

perspective health care is also considered as the diagnosis, treatment, and prevention of

disease, illness, injury, and other physical and mental impairments in human beings. Health

care is delivered by practitioners in allied health, dentistry, midwifery-obstetrics, medicine,

nursing, optometry, pharmacy, psychology and other care providers. It refers to the work

done in providing primary, secondary, and tertiary care, as well as in public health (Medical

Dictionary, 2007; PATH 2, 2014; WHO, 2010).

Busu (2009) explained that health care systems are designed to meet the health care need of

target population, stressing that there is a wide variety of health care systems around the 1

world. In some countries, the health care system has evolved and has not been planned,

whereas in others a concerted effort has been made by governments, trade unions, charities,

religious or other coordinated bodies to deliver planned health care services targeted to the

population they serve.

Accessibility is a relative nearness and approachability of one place to another. It suggests the

ease of reaching a destination from an origin (Jaro, 1999). Accessibility could also be

concerned with the opportunity that an individual at a given location possesses to participate

in a particular activity or set of activities or represents the ease with which activities may be

reached from a given location by means of a particular transportation system. It is usually

measured in terms of travel distance, time or cost. The less time and money spent in travel,

the more activities that can be reached in a given amount of time and the greater the

accessibility (Zhu and Liu, 2004).

Access to healthcare system is difficult to define. It is a multidimensional process that in

addition to the quality of care, involves geographical accessibility, availability of the right

type of care for those who need it, financial accessibility, and acceptability of service.

Geographic accessibility, the distance that must be traveled in order to use health facility,

may present an important barrier of access to healthcare. Access to healthcare facilities is a

significant factor that contributes to a healthy population and an important component of an

overall healthcare system and has a direct impact on the burden of diseases that affects many

countries, especially in the developing world (Al-Taiaret, Allan, Joseph, and Witty, 2010).

Accessibility to healthcare facilities has been measured in different ways, depending on the

context of the application, particularly in health care system and planning. Halden,

McGuigan, Nisbet and McKinnon (2000) view accessibility to healthcare as the ability of a

population to obtain a specified set of health care services. In this context, geographic

2

accessibility is often referred to as spatial or physical accessibility. Physical accessibility

addresses the complex relationship between the distribution of the population and the supply

of healthcare facilities (Ebener, Ray, Black and El Morjani, 2005). Spatial accessibility to

healthcare refers to the ease with which residents of a given area can reach medical services

and facilities (Hewko, Smoyer-Tomic, and Hodgson, 2002).

The availability and access to health care varies across countries, groups, and individuals,