In collaboration with Payame Noor University and Iranian Geography and Urban Planning Association

Document Type : Research Paper

Author

Associate Professor, Department of Geography, Payam Noor University, Tehran, Iran

10.30473/psp.2026.75319.2778

Abstract

Access to healthcare services is considered a fundamental and universal human right, and any disruption in this regard threatens the well-being and welfare of society. The main assumption of this study is that in many areas, particularly in large metropolitan cities, equal access to such services is not available to most citizens. Consequently, those deprived of these services perceive themselves as disadvantaged and react negatively to this inequality. To test this assumption, the present study was conducted in Mashhad using a descriptive-analytical approach. The required data included the location of healthcare centers at different levels as well as their facilities and equipment, which were collected through fieldwork. The data were then analyzed using the P-median model and mapped with the aid of Geographic Information Systems (GIS). The findings revealed that healthcare centers in Mashhad are not properly or accurately located across the city, and the facilities and equipment allocated to these centers are insufficient, forcing citizens to spend considerable financial and time resources to reach better-equipped centers. This situation not only leads to dissatisfaction and negative reactions among citizens but also contributes to traffic congestion, air pollution, and other environmental issues throughout the city. Therefore, a fundamental revision in the spatial distribution of healthcare centers, their equipment, and human resources is essential.

Keywords

Ahmed, S. J. (2004). Improving access to public health care services- a case study on Dar es Salaam, Tanzania. Dar es Salaam: International Institute for Geo-Information Science and Earth Observation.
Ajzaeshokohi, M., Bakharzi, S.M., & Alizadeh, M. (2014). Analysis of the spatial distribution of medical centers (clinics) in Region 4 of Mashhad Municipality), 6th Conference on Urban Planning and Management. Ferdowsi University and Mashhad Municipality, Mashhad, 11 November 2014. [In Persian].
Ajzaeshokohi, M., Khakpour, B., & Danaei-Fard, A. (2012). Investigation and analysis of the distribution of pressure in medical centers in Mashhad using GIS. Fourth Conference on Urban Planning and Management, Mashhad, https://civilica.com/doc/164835[In Persian].
Alvandipour, N., & Dadashpour, H. (2018). Meta-research Methods Related to Urban Spatial Justice in Iran in the Period of 2005- 2015. Urban Ecology Researches, 9(18), 69-86. https://dor.isc.ac/dor/20.1001.1.25383930.1397.9.18.5.9. [In Persian].
Amer, S. (2007). Towards Spatial Justice in Urban Health Services Planning: A spatial-analytic GIS-based approach using Dar es Salaam, Tanzania as a case study. Dar es Salaam: International Institute for Geo-Information Science and Earth Observation.
Banerji, S., & Fisher, H. B. (1974). Hierarchical location analysis for integrated area planning in rural India. Papers Regional Science Association, 33, 177-194.
Bellantuono, L., Bellotti, R., Stefania Bergantino, A., Gardelli, A., Intini, M., Kheirkhahan, N., & Monturano, G. (2025). Analyzing the accessibility of Rome’s healthcare services via public transportation: a complex network approach. Sci Rep. 15: 1-11. https://doi.org/10.1038/s41598-025-05060-7.
Cheng, R. W., Chin, T. L., & Huang, C. C. (2007). Optimal selection of location for Taiwanese hospitals to ensure a competitive advantage by using the analytic hierarchy process and sensitivity analysis. Building and Environment, 42(3), 1431-1444.
Daskin, M. S., & Dean, L. K. (2004). A Handbook of OR/MS in Health Care: Health Care Facilities. Northwestern: Northwestern University.
Drezner, T., & Drezner, Z. (2007). The gravity p-median model. European Journal of Operational Research, 179, 1239-1251.
Eaton, D. J., Hector, M. L., Sanchez, U., Ricardo, R. L. & Morgan, J. (1986). Determining ambulance deployment in Santo Domingo, Dominican Republic. Journal of Operational Research Society, 37, 113-126.
Feitosa, F., Hendrik Wolf João, J.,  & Lourenço Marques, J. (2024). Operationalizing spatial justice in urban planning: bridging theory with practice. Urban Research & Practice, 17(2), 1-17. http://dx.doi.org/10.1080/17535069.2024.2341254
Hajinejad, A., Tolabinejad, M., & Sadeghi, K. (2019). Optimal location of rural health and treatment centers using ANP and GIS (case study: Rashtkhwar Rural District, Khorasan Razavi). Human Settlement Planning Studies, 51: 79-100. [In Persian].
Ibrahim, O., & Graham, K. R. (2003). A goal-Programming model applied to the EMS at Riyadh City, Saudi Arabia. www.lums.lancs.ac.uk/publications/viewpdf/000177.
Koohi, K. (2023). Sociological explanation of investors' satisfaction with the police. Applied Sociology, 34(89), 1-30. [In Persian].
Lavi, M. (2008). Investigating spatial inequalities in access to public health services and providing strategies for its improvement: A case study of Region 10 of Isfahan Municipality. Master's thesis in Urban Planning, Shahid Beheshti University. [In Persian].
Luo, W., & Wang, F. (2003). Measures of spatial accessibility to health care in a GIS environment: synthesis and a case study in the Chicago region. Journal of Environment and Planning B: Planning and Design, 30, 865-884.
Marsousi, N., & Saebi, M.H. (2009). Geographical analysis of the impact of social ecology on the physical development of the city, case study: Mashhad city. Quarterly Journal of Urban Ecology Research, 1(1), 73-93. [In Persian].
Mashhad Municipality (2024). Mashhad Municipality Statistics yearbook.
Mashhad: Mashhad Municipality.
Mirkatoli, J. Ariankia, M., & Mirkarimi Aghche, R. (2015). Spatial analysis of urban services with a spatial justice approach, case study: Ilam city. Geographical Planning of Space, 15(1), 1-19. [In Persian].
Moradi, H. (2007). Location of health centers in Isfahan city. Master's thesis in Industrial Engineering, Isfahan University of Technology. [In Persian].
Pilerudi, C. (2006). Shahrestan Health and Treatment Network. United Nations Children's Fund (UNICEF: Razavieh Publications. [In Persian].
Planning and Budget Organization (2000). Inpatient and Specialized Medical Services System of the Country. Tehran: Planning and Budget Organization. [In Persian].
Qosiri, K., Ghanadpour, S. F., & Askari Tehrani, M. (2006). Location of emergency centers in urban transportation network using genetic algorithm. Fifth International Conference on Industrial Engineering. [In Persian].
Robbins, A. (1980). Fundamentals of Organizational Behavior, translated by Qasim Kabiri. Tehran: Islamic Azad University Publishing Center. [In Persian].
Saberifar, R. (2019). Study of the geographical distribution of coronavirus patients in Mashhad city based on the re-hunting method and the application of geographic information systems. Health-oriented Research, 6(1), 25-38. [In Persian].
Saberifar, R. (2021). Investigating the effect of deprivation on social well-being in inefficient urban contexts (case study of Mashhad city). Urban Sociological Studies, 11(38), 1-26. [In Persian].
Saberifar, R. (2023). Factors related to the selection of survival strategies by the urban poor among residents of inefficient urban areas of Torbat-e-Jam city. Social Welfare, 23(89), 129-163. [In Persian].
Sadeghipour, S. (2025). Investigating the status of access to medical infrastructure and satisfaction of social security insured persons in Mashhad city. Thesis for the Degree of M.A. In Sociology, University of Payam e Noor University.
Shams-ur Rahman, SDK. (2000). Invited Review Use of location allocation models in health service development planning in developing nations. European Journal of Operational Research, 123, 437-452.
Sharifzadegan, M. H., Mamdohi, A., & Lavan, M. (2010). Spatial inequality in access to public health services for urban health development through the p-median model in Isfahan city. Social Welfare Scientific and Research Quarterly, 10(37), 265-285. [In Persian].
Smith, D. M. (1974). Who gets what where and how: a welfare focus for human geography. Geography, 5, 289-297.
Thiede, M., & Koltermann, K.C. (2013). Access to health services - Analyzing non-financial barriers in Ghana, Rwanda, Bangladesh and Vietnam using household survey data, A review of the literature. New York: UNICEF.
Toregas, C.,  Swain, R.,  ReVelle, C., & Bergman, L. (1971). The Location of Emergency Service Facilities. Operations Research, 19(6), 1363-1373.
Toregas, C., Sawain, R., Revelle, C., & Bergman, L. (1971). The location of emergency service facility. Operations Research, 19, 1363-1373.
Wang, F. (2006). Quantitative Methods and Applications in GIS. London: CRC Press.
Wang, F., & Luo, W. (2005). Assessing spatial and nonspatial factors for healthcare access: towards an integrated approach to defining health professional shortage areas. Journal of Health & Place, 11, 131-14.