Seeing Health from Above: Remote Sensing and GIS Evidence for Bridging Primary Health Care Access Inequities
Fedri Ruluwedrata Rinawan (a*), Salma Ziani Nazwa Mulyana (b), Fidya Meditia Putri (c)

a) Department of Public Health, Faculty of Medicine, Universitas Padjadjaran
Jalan Ir. Soekarno No.KM. 21, Hegarmanah, Jatinangor, Sumedang Regency, West Java 45363
*f.rinawan[at]unpad.ac.id
b) Undergraduate Study Program, Faculty of Medicine, Universitas Padjadjaran
Jalan Ir. Soekarno No.KM. 21, Hegarmanah, Jatinangor, Sumedang Regency, West Java 45363
c) Department of Dental Public Health, Faculty of Dentistry, Universitas Padjadjaran
Jalan Ir. Soekarno No.KM. 21, Hegarmanah, Jatinangor, Sumedang Regency, West Java 45363

Abstract

Access to Primary Health Care (PHC) remains a fundamental challenge in achieving Universal Health Coverage (UHC). In Indonesia, the National Health Insurance (Jaminan Kesehatan Nasional/JKN) aims to ensure equitable access to first-level health facilities (Fasilitas Kesehatan Tingkat Pertama/FKTP). However, disparities persist, particularly in rapidly urbanizing areas. Our case study in Citeureup Subdistrict, Cimahi, West Java, used Geographic Information System (GIS) analysis to assess spatial accessibility for JKN participants. By applying both buffer and network analyses, we measured the distance from patient residences to the nearest FKTP and classified locations as near (<1 km) or far (>1 km). Findings revealed that a substantial proportion of residents live beyond the optimal service radius, with road network patterns further limiting access. These results highlight geographic proximity as a key factor influencing facility selection, alongside perceived quality and service availability.

Building on these local insights, we extended the research through a systematic literature review (SLR) examining how remote sensing (RS) can enhance the measurement of PHC accessibility. The SLR, conducted according to PRISMA guidelines, synthesized global evidence on RS-derived variables-such as built-up density, road quality, elevation, vegetation indices, hydrological barriers, and climatic conditions-and their integration into health access models. Studies demonstrated that RS data improve travel-time modeling, identify underserved populations, and inform more accurate facility placement, especially when combined with GIS-based spatial analysis.

By linking a ground-level case study with a global evidence synthesis, this research offers a dual perspective: detailed local diagnosis and broader methodological context. The approach underscores the potential of integrating RS and GIS to guide infrastructure planning, optimize facility distribution, and address inequities in PHC access. These findings are relevant for policymakers, public health planners, and researchers aiming to design data-driven strategies that bridge gaps in essential health services.

Keywords: Primary Health Care, accessibility, remote sensing, GIS, systematic review

Topic: Topic B: Applications of Remote Sensing