Alpha Omega Alpha Honor Medical Society

2011 Research Abstract

Access and Barriers to Health Services Vary Among Three Neighboring Honduran Communities

Investigator: Catherine Pearson, BA, Virginia Commonwealth University School of Medicine

Co-investigator: Kakotan Sanogo, MS, Virginia Commonwealth University School of Medicine

Mentor: Gonzalo Bearman MD, MPH, FACP, and Michael Stevens, MD, MPH, Virginia Commonwealth University School of Medicine

This study sought to describe and compare access and barriers to healthcare in three proximal yet topographically distinct Honduran communities served by the non-profit organization the Honduras Outreach Medical Brigada Relief Effort (HOMBRE). One site (Coyoles) is suburban while Lomitas and La Hicaca are mountainous and rural. All are under the auspices of the same local health authority. Study personnel employed an IRB approved, 25-item questionnaire at the point of care to persons attending the June 2011 HOMBRE clinics. We described and compared responses between sites. Three-way Chi-squared and Fisher Exact tests were employed to measure statistical difference. We performed 220 surveys: 50 in Lomitas, 30 in La Hicaca, 140 in Coyoles. In Lomitas, 70% of respondents reported no contact with a healthcare provider in the last 12 months, compared to 43% in La Hicaca, and 28% in Coyoles (p<0.0001). A majority (56%) of Lomitas respondents reported a 3-8 hour trip to access their health provider. A 1-3 hour trip was reported by 36% Lomitas, 80% La Hicaca, and 14% Coyoles (p<0.0001). A majority (59%) of respondents in Coyoles accessed their provider in <30 minutes. Major barriers to care were cost (88% Lomitas, 63% La Hicaca, 52% Coyoles, p<0.0001), facility overcrowding (94% Lomitas, 73% La Hicaca, 66% Coyoles, p=0.0006), availability of transportation (90% Lomitas, 67% La Hicaca, 37% Coyoles, p<0.0001), and distance to clinic (92% Lomitas, 67% La Hicaca, 37% Coyoles, p<0.0001). Despite geographic proximity and oversight by the same local health authority, remote Honduran communities experience greater burdens in healthcare access and barriers than neighboring communities of the same region. Barriers include cost, facility overcrowding, transportation and distance to clinic. These findings highlight the need for a more in depth understanding of individual community health needs in Honduras, and should be used for planning of future medical relief efforts.

Updated on May 23, 2012.

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