This literature review was undertaken by the authors with support from the World Health Organization and was completed in the early part of 1998. Its principal objective was to review the literature with a spatial/geographical research orientation and associated social health research with a country or region specific focus, published on Africa and African issues during the 1990s, In view of the very broad range of topics this subject could potentially cover and the time limitations on the project, a decision was made to focus the literature search on selected key journals and publications in English, with only essential reference to others. As the review had an explicit focus on spatial health research and related topics, the major sources reviewed were concerned with health geography, area studies and spatial aspects of public health. The main journals selected were Social Science and Medicine, Health and Place, Health Transition Review, Health Policy and Planning, Third World Planning Review, Transactions of the Institute of British Geographers, Area and World Health Forum, Publications by the Associations of American and Canadian Geographers were also searched and selected key books published in the period were also included although the focus was primarily on international refereed journals. For the purpose of this review, 'spatial health research' was taken to refer not solely to papers reporting studies of accessibility and utilization, location, GIS (Geographical Information Systems) or spatial modeling, but more widely to research which considers health and which has an explicit place or spatial element. The literature search was limited principally to books and articles published during the 1990s. The review has inevitably been selective and, whilst extensive, the literature was amenable to categorisation under fifteen sub-headings, with a smaller number of sub-sections. These sub-headings form a framework for the review of the literature as well as being indicative of key research areas in themselves. Some research publications clearly fall under more than one heading and, where this happens and is significant, cross-references are made. Certain perhaps obvious categories are not used. Population, for example, is not discussed as an individual topic except in the context of migration, population movements and their relations with health. Population is increasingly regarded as a cross-cutting issue that features in and, indeed, influences all other areas of human activity. Therefore, population change, growth, ageing and demographic and epidemiological transitions are discussed in the context of, for example, fertility, mortality and health care provision. We have similarly regarded gender as an all-pervasive issue and do not focus individually on women's or men's health but we do have a specific section focusing on maternal and child health in view of its prominence as a topic and in the literature on Africa. We have not dealt under a separate heading with the activities of donor or aid agencies but we have introduced these as and when relevant in other sections of the review. It might be considered somewhat unusual that, in a review covering the health geography literature, we have not focuses specifically on disease ecology. Rather, we have principally discussed diseases in their social and healthcare contexts as appropriate. The review was undertaken by the authors who are members of the Health Research Group in the Department of Geography in the University of Nottingham, UK, The Group is a WHO Collaborating Centre in Spatial Health Modelling and, with their partner, the Geografisch Instituut at the Vrije Universiteit, Brussels, form a resource for training and research in spatial health studies and analysis. The contact address of the Collaborating Centre is provided below. The authors are grateful for the support of WHO and, in particular, the encouragement of Dr. B. Mansourian, Director, Research Policy and Strategy Coordination, in the completion of this review.
|World Health Organization
|Published - 1998