The referral analysis allows one to compute the travelling times and/or the distances along the least-cost paths (i.e. path between two locations that minimizes the total travel duration for those travelling along it, see Ray and Ebener, 2008) between two groups of health centers. Such path is different from a straight line as it does take into account the landscape constraints together with the modes and speeds of travel of the population.
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(5) The "Permute group" option allows one to improve computation time when more facilities are selected in the starting group than in the destination one. But if this option is selected, 'Limit the spatial analysis to the closest pair time-wise' is not possible. We will not use this option for the exercise.
(6) The option "Output the layer of the paths among selected facilities", if checked, will output a polyline shapefile with all least-cost paths among all the start-destination pairs of points. We will not use this option for the exercise.
(7) The "Enable parallelization" option, if checked, allows the referral analysis to be parallelized on all available CPUs/cores that your AccessMod instance has access to, if it is possible, and if it is worth doing it with the available memory. If you are using Virtual box, the numbers of available cores can be changed in the settings of VirtualBox (see section 4.2). Using this option can drastically decrease the overall computation time for this analysis. We will not use this option for the exercise.
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In the above table, for example, you can notice that reaching the Queen Elizabeth Centre Hospital from the Chabvala Health Centre requires about 700 minutes of travel, but these two facilities are separated by only 50 km. If you look at the geographic locations of these two centers in a GIS software, you will see that a river (i.e., a barrier to movement) and the lack of roads in this area leads to require a long travel time before reaching the hospital. If you want to visualize the path between the two facilities, you can re-launch the analysis, but this time by selecting the option "Output the layer of the paths among selected facilities". The resulting shapefile can then be displayed in your GIS software.
This particular pair of health facilities also illustrates the impact that a barrier to movement can have on the output results. This calls for careful considerations when choosing the input layers and defining barriers to movements. For example, it that particular case considering the use of boats to cross the river at some point could have considerably reduced the travel time between the two facilities.
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