The current study characterised the diversity in healthcare services in Saudi Arabia's Jazan region through the use of pragmatic estimates of travel time by driving and walking to healthcare centres with dental treatment facilities.
More than any other metric, travel time accurately represents accessibility to healthcare centres. This study corroborated previous research showing that the maximum travel time to a health service should be between 5 and 60 min [8, 29], with served areas taking less than or equal to 30 min and underserved areas taking more than 30 min [30].
This study’s outcomes indicate a problem in the Jazan region concerning timely access to dental health services. The current study’s results are consistent with the findings of previous investigations. In Jeddah, Saudi Arabia, in 2018, it was discovered that several areas of the city lack access to health centres due to their location more than 30 min away [30], and in Makkah, Saudi Arabia, in 2021, it was discovered that a third of the city's population lacks adequate access to health care services due to the majority of health facilities being concentrated in the city's urban area, while rural and remote areas were neglected [31].
These findings are consistent with a 2016 study conducted in Mozambique, which discovered that many people require extensive travel time to access health care [8, 31]. This finding contradicted a study conducted in France, where 75% of the population needed less than 25 min to obtain health treatment [32].
Many residents of Jazan must drive for an extended period (> 30 min) to reach a health facility, whether it is a primary health care centre or a hospital. Residents of Al Darb have a shorter travel time to health services than residents of other governorates. This is explained by the equal population distribution, with half of the population living within the served area, reducing travel time to oral health care services. Additionally, Al Darb is located at the gateway to the Jazan region, allowing residents of Al Darb to easily travel to other closed regions for dental care. Additionally, the study discovered that most mountain governorates, including Al Aridah, Al Aydabi, Al Harth, Ar Rayth, Baysh, Fayfa, and Harub, had the largest proportion of individuals who lacked access to basic services. This could be because these places have fewer roads and more challenging driving conditions. This result is consistent with a previous study, which reported disparity in health care services due to geographical variance [33].
In the walking scenario, only 40% of Jazan region inhabitants require less than 30 min to reach PHCs, and only 19% require less than 30 min to reach hospitals, which is consistent with the study that discovered inadequate accessibility in the walking situation [34]. This could be explained by the absence of sidewalk infrastructure in this area, resulting in restricted access to facilities, which is consistent with the findings of the previous study [35]. However, the bulk of the population of Farasan and Damad was regarded to be in areas served by PHCs and hospitals. This could be because many individuals reside close to the government centres, and the area has an excellent infrastructure for walking.
In terms of population distribution, the study discovered that accessibility is more challenging for residents who need to walk to general hospitals; more than 80% of the Jazan region is underserved. The accessibility issue is almost identical to driving to primary health care centres (69%) or hospitals (68%). This analysis postulated that the entire population possessed a car, widely regarded as the primary mode of transport in Saudi Arabia [29]. This could be due to the small size of the population of these states, the fact that their basic infrastructure is still being developed, or the lengthy driving time to the facility [36]. Additionally, this could be because the majority of the region's residents live in major cities such as Sabya, Jazan, and Abu Arish, which is consistent with a study conducted in Makkah, which found that the bulk of the population lives in the city and one-third of the population lives far from health facilities, implying that they lack adequate access to health care services [31]. Also, a study in Jeddah discovered that many peripheral areas lacked health centres [29].
To address the consequences of insufficient dental service distribution, policymakers should consider expanding the number of health care facilities, particularly in underserved areas. Additionally, the public transportation network's infrastructure must be improved by constructing new roads or the rehabilitation of existing ones. Additional effort is required to map travel times to MOH, private, and other healthcare facilities throughout the region. Additional spatial and attribute variables regarding oral health status, dental services, providers, and the locations of private and other health facilities should be included. Additionally, a qualitative study will ascertain the public's and dental providers' concerns about dental health care access in Saudi Arabia.
To the researcher's knowledge, this is the first study to use QGIS to describe travel time to public dental healthcare services in Saudi Arabia's Jazan region. However, several limitations to the study should be considered. To begin with, there is a dearth of current information about dental health facilities (PHCs and hospitals). This study relied entirely on publicly available data and geographic divisions. At the time of the study, data on oral health services and providers were unavailable at the district level in the Jazan region, including the number of oral health providers (dentists, dental hygienists, and assistants), the type of service offered, waiting time, and characteristics of dental providers such as gender and speciality. Due to the rapid growth of the oral health and general health care systems, the data used in this study may not accurately reflect contemporary advancements. Additionally, the study excluded additional variables such as the location of patients seeking treatment, public transportation, and demographics such as age and gender from the calculation of realistic walking travel time. These issues should be looked into more intensely in future studies to get more accurate estimates of trip times.
Despite these shortcomings, this study possesses many strengths. This study estimated travel time to a health centre using the road network rather than straight lines. The road travel line is more precise and is frequently utilised by the general population [8, 37]. Additionally, the study used updated population data at the state level rather than at the administrative level to avoid skewed or aggregated population data. This study is especially beneficial for informing the distribution of health care facilities and the supply and inequalities in service provision in the region. Furthermore, this study will aid academic and health planners in determining journey times and road networks while also taking the mode of mobility into account.