Abstract: Provision of three basic infrastructure services (namely education, health and transport) in Rohtak and Bhiwani Districts (India) is examined using three types of data: 1. 507 households spreading in 8 villages, 2. Informal discussion with villagers and services providers in both districts, and 3. Secondary data for 921 villages and 14 towns and cities. These data were analysed using both statistical and GIS techniques. The analysis reveals that quantitatively there has been considerable expansion of education and health services over a period of fifteen years (1981 to 1996), and the average distance people have to travel to access these services has also declined significantly. But little evidence was found of any logical criterion being followed for the location of new services and the upgrading of existing services. Consequently, there was no improvement in the efficiency level (measured in terms of demand and geographical distance) of existing infrastructure services (both public and private); moreover, the efficiency level of private services was significantly lower than that of public services. It was further observed that the poor and women had relatively poor access to education, health and transport; and income, caste, gender, education level and village location had significant impact on access to and utilisation of basic services. In the study area, public services were functioning sub-optimally and service users were not satisfied with the quality of services; a significant proportion of clients had to rely on private services. Although public services may not be available in all the villages, the main focus should now be on improving the quality of existing services. Therefore, a solid transport network is needed in rural areas so that the availability of frequent and reliable transport services facilitate villagers' access to quality services even if located at distant places. Thus far, the role of the public in service provision has been minimal, which may be one of the reasons for poor quality of public services. Therefore, the active involvement of clients (service users) is essential in the operation, maintenance and monitoring of basic services in order to improve their quality and efficient functioning, and to effectively cater for people's needs in general and deprived sections of the society in particular.

Le secours à personne (SAP) correspond aux missions que réalisent les pompiers français pour porter secours en urgence aux victimes. Comme la démographie médicale, le nombre de pompiers volontaires est en baisse, particulièrement dans les espaces périurbains et ruraux. Parallèlement, le nombre d’interventions de type SAP est en augmentation constante, ce qui engendre localement des tensions entre l’offre et la demande en secours. Une des solutions pour remédier à cette situation consiste à optimiser la localisation des moyens existants. Cependant, les méthodes mises en œuvre pour cela, par les professionnels, ne sont pas suffisamment intégrées, et celles développées par les chercheurs, pas suffisamment opérationnelles. L’objectif de cette recherche est donc de proposer une méthode d’optimisation des localisations, à la fois intégrée et opérationnelle. Le choix s’est porté vers les modèles de localisation-allocation, car ils permettent de prendre en compte, de manière globale, l’ensemble des paramètres entrant en jeu dans la localisation des secours, ainsi que les conséquences en chaîne que les choix de localisation peuvent entraîner. La démarche se décompose en trois étapes. La première consiste à réaliser un diagnostic du SAP. La deuxième consiste à choisir et préparer les données d’entrée du modèle et le paramétrer. La troisième consiste à réaliser différents grands scénarios d’optimisation possibles. Cette démarche a permis de mettre en exergue les besoins de méthodes et d’outils d’optimisation opérationnels et de démontrer l’intérêt des modèles de localisation-allocation comme aide à la réflexion pour l’optimisation de la localisation des moyens de SAP. / In France, emergency rescue for victims is an integral part of the fire brigade missions. This is what we called the secours à personne (SAP). These last years, the number of volunteer firemen is in decline, particularly in the peri-urban and rural areas, which is not without consequence on the coverage of operational resources, especially since these sectors are already experiencing a decline in medical demography. At the same time, the number of SAP type of interventions is increasing. In this context, tensions between supply and demand for SAP tend to increase. One of the solutions envisaged to solve this situation is to optimize the location of existing resources. However, the methods implemented to this, by professionals, don’t prove to be sufficiently integrated, and those developed by researchers, not sufficiently operational. The main objective of this research is to propose an optimization method for localized SAP resources, both integrated and operational.The choice fell on the location-allocation models, because they take into account, overall, the set of parameters that come into play in the location of the emergency, and the consequences chain as location choices can result. The approach consists of three steps. The first is to make a diagnosis of SAP. The second is to select and prepare input data and configure the model. The third is to carry out various great scenarios optimization possible. This approach allowed, on one hand, to highlight the needs and methods of operational optimization tools, and on the other hand, to demonstrate the interest of the location-allocation models as an aid to reflection for optimizing localization of SAP resources.

Este estudo integrou sistemas de informação geográfica e métodos analíticos geoespaciais baseados em modelos de acessibilidade espacial e de locação-alocação com o objetivo de aprimorar o planejamento espacial de diferentes programas de saúde pública em áreas urbanas. Para estimar a acessibilidade espacial foi desenvolvido o modelo de três passos de área de influência flutuante (E3SFCA - Enhancement three-step floating catchment área) baseado em uma função Gaussiana, considerando um coeficiente de atrito e distâncias ao longo de uma rede de transporte, utilizando o algoritmo de Dijkstra. A metodologia foi aplicada e validada usando os programas de vacinação contra a raiva e de esterilização para cães e gatos da cidade de Bogotá, Colômbia. A escolha do método de cálculo da distância resolveu o problema de superestimação associado com a metodologia clássica que aplica zonas buffer em torno dos locais de serviço baseado em uma distância Euclideana. Em geral, não se encontrou uma adequada acessibilidade espacial aos dois programas. As zonas norte, central e periférica da cidade revelaram baixa ou nula acessibilidade aos serviços. Para determinar a alocação e realocação efetiva dos programas foram utilizados os problemas de máxima cobertura com demanda finita e de p-mediana ou de mínima impedância. A realocação proposta pelo modelo de máxima cobertura forneceu uma melhor distribuição dos serviços nas áreas mais povoadas com cães e gatos e garantiu uma acessibilidade espacial potencial a estes programas. O desenvolvimento deste trabalho pode trazer benefícios diretos para a sociedade em geral auxiliando no planejamento estratégico e melhorando a efetividade das ações públicas em áreas urbanas da América Latina. / This study integrated geographic information systems and geospatial analytical methods based on spatial accessibility and location-allocation models in order to improve the spatial planning of different public health programs in urban areas. To estimate the spatial accessibility, a Gaussian-based three-step oating catchment area (E3SFCA) method was developed, including a friction coeffcient and using distances along a street network based on Dijkstra\'s algorithm. The methodology was applied and valiated using the rabies vaccination and sterilization programs for dogs and cats in the city of Bogotá, Colombia. The choice of the distance calculation method solve the overestimation associated with the classic methodology that applies buffer zones around vaccination sites based on Euclidean (straight-line) distance. In general it was not observed an adequate spatial accessibility to both programs. The zones north, central and peripheral of the city revealed low or no access to services. To determine the effective allocation or reallocation of these programs the maximum coverage with finite demand and the p-median or minimum impedance problems were used. The relocation proposed by the maximum coverage model provided a better distribution of the services in the most populated areas and proportioned a potential spatial accessibility to these programs. The development of this work can provide direct benefits to society assisting in the strategic planning and improving the effectiveness of public policies in urban areas of Latin America.

Este estudo integrou sistemas de informação geográfica e métodos analíticos geoespaciais baseados em modelos de acessibilidade espacial e de locação-alocação com o objetivo de aprimorar o planejamento espacial de diferentes programas de saúde pública em áreas urbanas. Para estimar a acessibilidade espacial foi desenvolvido o modelo de três passos de área de influência flutuante (E3SFCA - Enhancement three-step floating catchment área) baseado em uma função Gaussiana, considerando um coeficiente de atrito e distâncias ao longo de uma rede de transporte, utilizando o algoritmo de Dijkstra. A metodologia foi aplicada e validada usando os programas de vacinação contra a raiva e de esterilização para cães e gatos da cidade de Bogotá, Colômbia. A escolha do método de cálculo da distância resolveu o problema de superestimação associado com a metodologia clássica que aplica zonas buffer em torno dos locais de serviço baseado em uma distância Euclideana. Em geral, não se encontrou uma adequada acessibilidade espacial aos dois programas. As zonas norte, central e periférica da cidade revelaram baixa ou nula acessibilidade aos serviços. Para determinar a alocação e realocação efetiva dos programas foram utilizados os problemas de máxima cobertura com demanda finita e de p-mediana ou de mínima impedância. A realocação proposta pelo modelo de máxima cobertura forneceu uma melhor distribuição dos serviços nas áreas mais povoadas com cães e gatos e garantiu uma acessibilidade espacial potencial a estes programas. O desenvolvimento deste trabalho pode trazer benefícios diretos para a sociedade em geral auxiliando no planejamento estratégico e melhorando a efetividade das ações públicas em áreas urbanas da América Latina. / This study integrated geographic information systems and geospatial analytical methods based on spatial accessibility and location-allocation models in order to improve the spatial planning of different public health programs in urban areas. To estimate the spatial accessibility, a Gaussian-based three-step oating catchment area (E3SFCA) method was developed, including a friction coeffcient and using distances along a street network based on Dijkstra\'s algorithm. The methodology was applied and valiated using the rabies vaccination and sterilization programs for dogs and cats in the city of Bogotá, Colombia. The choice of the distance calculation method solve the overestimation associated with the classic methodology that applies buffer zones around vaccination sites based on Euclidean (straight-line) distance. In general it was not observed an adequate spatial accessibility to both programs. The zones north, central and peripheral of the city revealed low or no access to services. To determine the effective allocation or reallocation of these programs the maximum coverage with finite demand and the p-median or minimum impedance problems were used. The relocation proposed by the maximum coverage model provided a better distribution of the services in the most populated areas and proportioned a potential spatial accessibility to these programs. The development of this work can provide direct benefits to society assisting in the strategic planning and improving the effectiveness of public policies in urban areas of Latin America.