This study identifies the variation in healthcare services in the Jazan region of Saudi Arabia by using pragmatic estimates of travel time for both driving and walking to health care facilities. This study will help researchers and health planners to explore travel time along road networks, considering the mode of transportation. Travel time provides a better indication of geographical accessibility issues than other measures . This study was in line with studies that stated the travel distance to health service within 5 min and 60 minutes as maximum travel times [6, 20] with served areas of fewer than or equal to 30 minutes and underserved areas of more than 30 minutes .
This study’s findings show that there is an issue regarding reaching health services in a reasonable time in the Jazan region. This result was similar to the finding in a similar study . Many people in Jazan need to drive for a long time (> 30 min.) to reach a health facility, whether it’s a PHC or hospital. Al Darb residents has a short time to reach health facilities compared to the other governates. This can be explained by the equal population distribution, since half of them live within the served area which means a shorter travel time to reach healthcare services. Also, Al Darb is located at the entrance to the Jazan region with other regions that allow Al Darb residents to move easily to other closed regions to receive healthcare. The study also found that most of the mountain governates such as Al Aridah, Al Aydabi, Al Harth, Ar Rayth, Baysh, Fayfa and Harub had the highest number of underserved residents. This could be because of the lower number of roads and difficult driving conditions in these areas.
Regarding the walking scenario, only 40% of Jazan region residents need 30 minutes or less to reach PHCs and only 19% of the residents need 30 minutes or less to reach hospitals. The majority of Farasan and Damad residents was considered a served area of PHCs and hospitals. This could be many people live close from the governates centres as well as has a good infrastructure for walking.
In terms of population distribution, the study showed that accessibility is mainly difficult when people need to walk to general hospitals; More than 80% of the Jazan region is in an underdeveloped area. The accessibility issue is almost like the scenario of driving to PHCs (69.27%) or hospitals (68.03%). Many people are using their own vehicles which is considered the main mode of transportation in Saudi Arabia . This is possibly because of the small population size, because these governates’ basic infrastructure is still under development, or due to prolonged driving time to the facility .
To combat the effects of poor dental service distribution, policy maker must consider increasing the number of healthcare facilities, particularly for the underserved areas. Also, the infrastructure of the public transport network must be improved by creating new roads or rehabilitating existing ones. More efforts are needed in mapping the travel time to MOH, private and other healthcare facilities in the region. More spatial and attribute variables should be included regarding oral health status, dental services and providers, private and other health facilities’ locations.
To the researcher's knowledge, the current study was the first to describe travel time to public dental healthcare service in the Jazan region of Saudi Arabia by using QGIS. However, the study has several limitations that should be considered. First, there is a lack of updated information regarding health facilities (PHCs and hospitals). This study only used openly accessible data and geographic divides. At the time of the study, there was an absence of data regarding oral health services and oral health providers in the Jazan region at the district level regarding the number of oral health providers (dentist, dental hygienists and assistants), type of service offered, waiting time, and characteristics of dental providers such as gender and type of specialty. Due to the rapid advancement of the dental health system and general healthcare system, previously collected data used in this study might not reflect recent developments. Also, the study didn’t include other factors such as where patients seek treatment, public transportation, and considered factors like age and gender to measure realistic travel time for walking travel time. These factors should be explored for better estimates of travel times in future studies.
Despite these limitations, this study has several strengths. This study used the road network rather than straight lines to estimate the travel time to the health facility. Using road travel line is more accurate and is normally used among the population [6, 23]. In addition, the study used updated population data based on governates levels, not administrative levels to avoid biased and aggregated population data. This study is particularly useful in informing the planning of health care facilities’ distribution and the supply and disparities of service availability in the region.