Geospatial Modeling of Accessibility and Site Suitability for Primary Health Care Centers in Najaf City, Iraq, through 2034

Abstract

Primary health care centers (PHCCs) are the most geographically proximate component of an urban health system, yet their effectiveness depends on how well facility locations correspond to population distribution, service reach, road connectivity, and land availability. This study develops a geospatial model that integrates current accessibility, future population requirements, and site suitability for PHCCs in Najaf City, Iraq, through 2034. Official records for 33 main PHCCs, neighborhood boundaries, population estimates, road and land-use layers, high-resolution imagery, and field observations were analyzed in ArcGIS 10.8 and ArcGIS Pro. The methods combined an 800-m Euclidean service buffer, mean center, central feature, standard distance, directional distribution, average nearest neighbor, geometric population projection, and a weighted-overlay GIS multicriteria decision analysis. The centers occupy 78,400 m², averaging 2,376 m² against a local planning standard of 5,000 m². The nearest-neighbor ratio (1.040522; z = 0.337907; p = 0.735434) indicates a statistically random pattern. Accessibility is highly uneven: the share of neighborhood area within an 800-m buffer falls to 4.0% in Al-Salam, 7.41% in Al-Iskan, and 8.14% in Al-Hanana. The 2024 population of 890,187 requires 89 centers, creating a deficit of 56; the projected 2034 population of 1,253,799 raises total normative need to 125 centers. The suitability model generated 42 high-ranking alternatives (scores 8–9), concentrated in Al-Nidaa, Al-Salam, Al-Askari, Al-Mukarrama, Al-Jami’a, and Al-Hussein, within approximately 230,000 m² of candidate land. A phased strategy that prioritizes high-suitability parcels within low-coverage neighborhoods offers a defensible basis for improving spatial equity and planning new PHCC provision through 2034.