For communities in urban and rural areas, access to healthcare facilities is a very significant concern of service delivery to both public policy makers and urban planners. Many healthcare systems set one of their primary objectives to achieve equity and ease of access to healthcare facilities for the populations that they serve. Spatial distribution of population, transport infrastructure, as well as spatial distribution of healthcare facilities are key characteristics that influence the disparities in spatial accessibility to healthcare facilities. Regardless of the permanent interest in transport accessibility, it is often uncertain how different types of accessibility measures relate to one another and which conditions are best for applications. In general, the current study undertakes a statistical comparison among three spatial accessibility measures (representing the main categories of spatial accessibility models) to determine whether they are comparable and/or interchangeable. Specifically, this study aims to use a geographical information system based approach combined with spatial accessibility measures, in a case study, derived from fine spatial resolution datasets, to characterise and divulge spatial variations in individual’s access to healthcare facilities and identify deprived locations/local communities in a selected District Municipality of the Western Cape, South Africa. Results indicate that the main categories of spatial accessibility measures provide different interpretations of accessibility that cannot be reproduced by each other. However, the accessibility measures show a significant similar trend in variations of individual’s accessibility to healthcare services for the communities of Cape Winelands District Municipality. The study establishes that within the Cape Winelands there exist spatial variations in the distribution of accessibility to healthcare and characterises these variations.

The tremendous need for comprehensive healthcare among underserved populations has been well documented. Most of the healthcare resources have been allocated to major metropolitan areas and largely populated cities. In Massachusetts alone, 500,000 people are not serviced by proper healthcare because they are unemployed or underinsured. They do not have a home base for their needs, most visit emergency rooms or minute clinics for care. They lack continuity of care. For minorities and underserved populations, there is a gap in the healthcare system. Statistics have shown that the lower your socioeconomic status, the more advanced the disease has progressed before it is diagnosed, leading to fewer treatment options and poorer outcomes. This is often due to Healthcare Deserts / Health Professions Shortage Areas in the US where there is a true lack of access to healthcare resources. One effective system for healthcare belongs to the Cuban government. Since the revolution in 1949, one of the main goals of the Cuban government was to provide primary care to all its population. The system before the revolution was centralized in the cities and was available mostly to the wealthy and urban populations while the remaining population was left with a substandard and underfunded system like many developed and undeveloped countries. In this paper, we will explore the success of the Cuban system and extrapolate some aspects of its system to use in the underserved populations that inhabit Healthcare Deserts. Implementation of systems will create an Oasis of providers that will naturally improve the well-being of populations leading to the well-being of federally funded state and local resources. The Cuban system divided the country into a grid system and each grid was subsequently divided into even smaller areas with a population of approximately one thousand. A primary care team consisting of a doctor and a nurse was assigned to each grid, including a dental component, and charged with the health and well-being of the population. This system was so successful that it was exported to other countries such as Venezuela, and it was adopted by the World Health Organization as the healthcare model standard to be followed in their world efforts. These programs have been implemented in Latin America, Africa, and Asia with different levels of success due to resource availability and financial constraints. In Venezuela during the Chavez administration, the system was implemented and achieved its highest level of success by benefiting the poor and underserved while Chavez was in power, creating thousands of clinics and improving the healthcare of the population. In Africa, Tanzania adopted the primary care approach at its new dental school and is producing strong clinicians versed with this approach. In Asia, the WHO has made progress in some areas; however, success has proven dependent on the country’s political and financial situation. The primary care approach that the system embraces, emphasizes prevention and education at a very early stage. This is key, and the data proves the success of campaigns even with limited resources provided there is the involvement of the local population. In contrast, United States resources are concentrated on the coasts and urban locations such that the rural areas have the least resources, and people in rural locations often travel long distances to access healthcare. A few states in the US have implemented programs that have been successful – Colorado, North Carolina, and New Mexico. If we successfully transplant teams of healthcare providers, including doctors, dentists, nurses, pharmacist, optometrist, obstetrics /gynecology, pediatricians, and a complete and sustainable health center into empty grids, slowly a series of Oasis will be created and access to care will improve. This change needs to happen at multiple levels, it is a task that must be taken collectively, from the teaching institutions exposing healthcare students to the need for providers in these rural and underserved areas, increasing funding to provide more scholarships and programs that funnel recent graduates into these areas with a sustainable and self-replenishing model, and most important, emphasizing education and prevention in dental school curriculum as the key to improving healthcare, and creating Oases in the current deserts.