An interaction-based location–allocation model for health facilities to limit the spread of HIV–AIDS in West Africa

An effective way to limit the spread of HIV–AIDS through the activities of Indinavir (IDVs) is to provide a health facility system that reduces bypassing and IDV use. Bypassing does not spread HIV–AIDS; it indicates the level of unmet need most likely serviced by IDVs. In the West African context, bypassing is a proxy for the risk of HIV–AIDS exposure through poor access to health services. Arguably, better-equipped and staffed health facilities in rural areas would attract more users, induce greater usage and reduce patronage of IDVs. Nevertheless the difficult economic conditions prevailing in countries of West Africa make significant improvements in the system infeasible. Providing attractive health facilities in every village is not possible. It is essential to select strategically located towns and villages to provide excellent services to induce greater use. This article explores a location–allocation model for locating health facilities to reduce bypassing and increase usage. Its underlying thesis is that given the endemic nature of many infectious diseases in West Africa and the high demand for health care, particularly injections, improved rural access to quality formal health facilities may curtail bypassing and the need to use IDVs and, thus, reduce HIV–AIDS risk. Compared to the current situation where most HIV–AIDS screening facilities are located in urban centers, such a system of facilities will also ensure better access to HIV–AIDS screening and diagnosis in rural areas. The article begins with a brief examination of the health care system. Following this, the model is presented and, finally, applied to Suhum–Kraboa–Coaltar, a rural district in Ghana.