Healthcare Access in Azuay: Analyzing the Offer of Primary Care Physicians in 2018

Abstract

Despite a recent increase in the number of physicians, population health indicators associated with Primary Health Care (PHC) objectives in Azuay remain stagnant. The availability and equitable distribution of primary care doctors are critical, as they serve as the first point of contact within the healthcare system and are responsible for addressing the majority of health concerns. This study evaluates the supply and spatial distribution of primary care physicians in Azuay during 2018, compares findings to international standards, and identifies urban-rural disparities. A quantitative, descriptive, cross-sectional analysis was conducted using data from the National Institute of Statistics and Censuses (INEC) through the publicly available dataset Recursos y Actividades de Salud 2018. Results indicate that 56% of the province’s primary care physicians were concentrated in Cuenca canton. Cuenca and Girón were the only cantons to meet the World Health Organization’s recommended physician-to-population ratio of 23 per 10,000 inhabitants. However, when focusing exclusively on first-level care physicians, no canton met the standard. This reveals both a quantitative shortage and an inequitable distribution of physicians, particularly disadvantaging rural areas. In conclusion, Azuay province experiences a significant shortfall in primary care physicians, coupled with marked disparities in urban versus rural coverage. Targeted strategies are needed to redistribute human health resources and ensure progress toward PHC goals.