Geographical analysis of cesarean delivery in relation to the coverage of hospital servicesCase study: Razavi Khorasan province

The lives of babies and mothers are at risk due to the unequal distribution of health care facilities needed for emergency caesarean section. However, cesarean delivery without medical indications may cause complications for mothers and babies.The purpose of this research is to analyze the geographic-spatial pattern of cesarean delivery in relation to access to medical services. In this regard, spatial accessibility survey models, network analysis, buffer analysis, and Thiessen's or Vouroni's polygon analysis were used. The data of this research includes 30 cities of Razavi Khorasan province.The findings of this research showed that cesarean births in Razavi Khorasan (35.39) were higher than the standard of the World Health Organization (5-15% of all births). The distribution of cesarean rates in the study area was not uniform and a kind of inhomogeneity was observed in the distribution of rates. So that some cities have experienced higher ratios of cesarean rates. The findings related to the analysis of buffer and network analysis showed that the cities located in the east and south were outside the coverage of medical services and the residents of these areas had to travel to other cities to access services. Also, the findings related to the analysis of Thiessen's polygons brought a broader and more comprehensive view of access to medical services within the scope of the research. And it showed that the range or coverage of medical services is inconsistent in the entire scope of the research.Finally, hospital capacity and distance from population centers to hospitals may play a major role in changes in cesarean delivery rates and spatial interactions between people and cesarean delivery facilities. Consequently, some health care strategies, for example, building new hospitals and enabling existing local hospitals to perform cesarean deliveries in out-of-service areas, may be developed to reduce spatial inequality.