A geospatial analysis of two-hour surgical access to district hospitals in South Africa

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A geospatial analysis of two-hour surgical access to district hospitals in South Africa


JournalBMC Health Serv Res
Publication date – Aug – 2020
Authors – Kathryn M Chu, Angela J Dell, Harry Moultrie, Candy Day, Megan Naidoo, Stephanie van Straten, Sarah Rayne
KeywordsDistrict Hospital, Geographic information systems, global surgery, South Africa, Surgical access, Surgical capacity
Open access – Yes
SpecialityEmergency surgery, Health policy, Obstetrics and Gynaecology
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on August 30, 2020 at 11:40 pm
Abstract:

Background
In a robust health care system, at least 80% of a country’s population should be able to access a district hospital that provides surgical care within 2 hours. The objective was to identify the proportion of the population living within 2 hours of a district hospital with surgical capacity in South Africa.

Methods
All government hospitals in the country were identified. Surgical district hospitals were defined as district hospitals with a surgical provider, a functional operating theatre, and the provision of at least one caesarean section annually. The proportion of the population within two-hour access was estimated using service area methods.

Results
Ninety-eight percent of the population had two-hour access to any government hospital in South Africa. One hundred and thirty-eight of 240 (58%) district hospitals had surgical capacity and 86% of the population had two-hour access to these facilities.

Conclusion
Improving equitable surgical access is urgently needed in sub-Saharan Africa. This study demonstrated that in South Africa, just over half of district hospitals had surgical capacity but more than 80% of the population had two-hour access to these facilities. Strengthening district hospital surgical capacity is an international mandate and needed to improve access.

OSI Number – 20638
PMID – 32791995

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