Spatial Distribution and Inequalities in Pediatric Healthcare Services in Kinshasa: A GIS-Based Assessment of Health Equity

Jean Pierre Kambondji Bukaya; Patrick Ngoie Mululu; Jean Claude Kamanda wa Kamanda; Kabamba Kabata; Aketi Loukia

Jean Pierre Kambondji Bukaya
Patrick Ngoie Mululu
Jean Claude Kamanda wa Kamanda
Kabamba Kabata
Aketi Loukia

Keywords: Health geography, Pediatric healthcare, Spatial accessibility, Geographic Information Systems, Urban health inequalities, Kinshasa

Abstract

Rapid urban growth in many African cities has intensified spatial inequalities in access to healthcare services, particularly for vulnerable populations such as children. This study analyzes the spatial distribution and territorial disparities of pediatric healthcare services in Kinshasa, Democratic Republic of Congo, using Geographic Information Systems (GIS) and spatial statistical methods.

Data were collected from health facilities providing pediatric services across 11 sampled health zones out of the 35 existing zones in Kinshasa. Spatial datasets and demographic information were integrated into a GIS environment to assess healthcare distribution, facility density, and accessibility. Spatial analyses included density mapping, buffer-based accessibility analysis (500 m, 1 km and 2 km), and spatial autocorrelation using Moran’s I.

The results reveal a strong spatial concentration of pediatric healthcare facilities in central and peri-central communes, particularly in Gombe, Lingwala and Kasa-Vubu. These areas show the highest facility densities, exceeding 2.5 structures per km² and more than 4 facilities per 10,000 inhabitants. In contrast, peripheral communes such as Kimbanseke, Mont-Ngafula and Kisenso display significantly lower service densities, often below 0.5 facilities per km² and fewer than 1 facility per 10,000 inhabitants.

Spatial analysis also indicates a significant clustering pattern of healthcare facilities (Global Moran’s I = 0.34, z-score = 3.21, p < 0.01), confirming a polarized spatial structure of pediatric healthcare provision. Large peripheral areas remain underserved, with populations located more than 2 km from the nearest pediatric facility.

These findings highlight substantial territorial inequalities in pediatric healthcare accessibility in Kinshasa. Integrating spatial analysis into urban health planning could help identify priority areas for infrastructure development and improve equitable access to child healthcare services.

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