Impact on pregnant/parturient women's health resulting from displacement between residence and health service

Keywords: Health; Health Impact Assessment; Pregnant Women; Health Services; Locomotion.


Objective: to analyze the impact on pregnant/parturient women's obstetric and neonatal outcomes resulting from displacement between homes and health services. Methods: an integrative review was carried out in August 2020 on the following databases: SCOPUS, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online/PubMed, Science Direct and Latin American and Caribbean Health Sciences Literature/Virtual Health Library, using controlled descriptors and keywords. Besides, a quantitative descriptive analysis of the main results was performed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software. Results: the sample resulted in 20 articles. It was evidenced that the mobility of women is hampered by distance between home and health services, precarious transport, and living in socioeconomically disadvantaged places. Conclusion: difficulty in mobility is a crucial factor that explains the adverse maternal and neonatal impact.


Monte AS, Mendes IC, Oriá MOB, Carvalho FHC, Brown H, Damasceno AKC. Near miss maternal: influencing factors and guidelines for reducing maternal morbidity and mortality. Rev Rene. 2018; 19:e3182. doi:

Chávez GM, Viegas SMF, Roquini GR, Santos TR. Access, accessibility, and demand at the family health strategy. Esc Anna Nery. 2020; 24(4):e20190331. doi:

Bloch JR, Cordivano S, Gardner M, Barkin J. Beyond bus fare: deconstructing prenatal care travel among low-income urban mothers through a mix methods GIS study. Contemp Nurse. 2018; 54(3):233-45. doi:

Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs, 2005; 52(5):546–53. doi:

Camargo BV, Justo AM. IRAMUTEQ: Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Temas Psicol. 2013; 21(2):513-8. doi:

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. Phys Ther. 2009; 89(9):873-80. doi:

Parkhurst JO, Ssengooba F. Assessing access barriers to maternal health care: measuring bypassing to identify health Centre needs in rural Uganda. Health Policy Plan. 2009; 24(5):377-84. doi:

Gabrysch S, Cousens S, Cox J, Campbell OMR. The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS Med. 2011; 8(1):e1000394. doi:

Grzybowski S, Stoll K, Kornelsen J. Distance matters: a population-based study examining access to maternity services for rural women. BMC Health Serv Res. 2011; 11:147. doi:

Gething PW, Johson FA, Frempong-Ainguah F, Nyarko P, Baschieri A, Aboagye P, et al. Geogra- phical access to care at birth in Ghana: a barrier to safe motherhood. BMC Public Health. 2012; 12:991. doi:

Silal SP, Penn-Kekana L, Harris B, Birch S, Mclntyre D. Exploring inequalities in access to and use of maternal health services in South Africa. BMC Health Serv Res. 2012; 12:120. doi:

Yao J, Murray AT, Agadjanian V. A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Soc Sci Med. 2013; 96(1):60-8. doi:

Kitui J, Lewis S, Davey G. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy Childbirth. 2013; 13(40):1-10. doi:

Tsawe M, Susuman AS. Determinants of access to and use of maternal health care services in the Eastern Cape, South Africa: a quantitative and qualitative investigation. BMC Res Notes. 2014; 7:723. doi:

Okwaraji YB, Webb EL, Edmond KM. Barriers in physical access to maternal health services in rural Ethiopia. BMC Health Serv Res. 2015; 15:493. doi:

Ansari MS, Manzoor R, Siddigui N, Ahmed AM. Access to comprehensive emergency obstetric and newborn care facilities in three rural districts of Sindh province, Pakistan. Health Res Policy Syst. 2015; 13(55):57-98. doi:

Chong S, Byun R, Jalaludin BB. A feasibility study using geographic access to general practices and routinely collected data in public health and health services research. Public Health Res Pract. 2015; 25(4):e2541542. doi:

Munguambe K, Boene H, Vidler M, Bique C, Sawchuck D, Firoz T, et al. Barriers and facilitators to health care seeking behaviours in pregnancy in rural communities of southern Mozambique. Reprod Health. 2016; 13(1):83-97. doi:

Vadrevu L, Kanjilal B. Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans. Int J Equity Health. 2016; 15:87. doi:

Panciera R, Khan A, Rizvi SJR, Ahmed S, Ahmed T, Islam R, et al. The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study. BMC Pregnancy Childbirth. 2016; 16(1):240. doi:

Sacks E, Vail D, Austin-Evelyn K, Greeson D, Atuyambe LM, Macwan’gi M, et al. Factors influencing modes of transport and travel time for obstetric care: a mixed methods study in Zambia and Uganda. Health Policy Plan. 2016; 31(3):293-301. doi:

Makanga PT, Schuurman N, Sacoor C, Boene HE, Vilanculo F, Vidler M, et al. Seasonal variation in geographical access to maternal health services in regions of southern Mozambique. Int J Health Geogr. 2017; 16:1. doi:

Chen YN, Schmitz MM, Serbanescu F, Dynes MM, Maro G, Kramer MR. Geographic access modeling of emergency obstetric and neonatal care in Kigoma region, Tanzania: transportation schemes and programmatic implications. Global Health Sci Pract. 2017; 5(3):430-45. doi:

Wang W, Winner M, Burgert-Bruckera CR. Limited service availability, readiness, and use of facility-based delivery care in haiti: a study linking health facility data and population data. Global Health Sci Pract. 2017; 5(2):244-61. doi:

Yasuoka J, Nanishi K, Kikuchi K, Suzuki S, Ly P, Thavrin B, et al. Barriers for pregnant women living in rural, agricultural villages to accessing antenatal care in Cambodia: a community-based cross-sectional study combined with a geographic information system. PLoS One. 2018; 13(3):e0194103. doi:

Schmitz MM, Serbanescu F, Kamara V, Kraft JM, Cunningham M, Opio G, et al. Did saving mothers, giving life expand timely access to lifesaving care in Uganda? A spatial district-level analysis of travel time to emergency obstetric and newborn care. Global Health Sci Pract. 2019; 7(1):151-67. doi:

Viegas APB, Carmo RF, Luz ZMP. Fatores que influenciam o acesso aos serviços de saúde na visão de profissionais e usuários de uma unidade básica de referência. Saúde Soc. 2015; 24(1):100-12. doi:

Maciazeki-Gomes RC, Souza CD, Baggio L, Wachs F. The work of the community health worker from the perspective of popular health education: possibilities and challenges. Ciênc Saúde Coletiva. 2016; 21(5):1637-46. doi:

Willey B, Waiswa P, Kajjo D, Munos M, Akuze J, Allen E, et al. Linking data sources for measurement of effective coverage in maternal and newborn health: what do you learn from individual-vs ecological-linking methods? J Glob Health. 2018; 8(1):010601. doi:

Lera I, Perez T, Guerrero C, Eguiluz VM, Juiz C. Analysing human mobility patterns of hiking activities through complex network theory. PLoS One. 2017; 12(5):e0177712. doi:

Review Article