ArticleWorld journal of surgery2015
Barriers to Essential Surgical Care in Low- and Middle-Income Countries: A Pilot Study of a Comprehensive Assessment Tool in Ghana.
Article in World journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Application of the Three Delays Framework to Assess Barriers to Surgical Care in an East African Refugee Camp: A Cross-sectional Survey Among 1,135 Adults.The Journal of surgical research · 2026Article
- Global Barriers to Otolaryngology Care.JAMA otolaryngology-- head & neck surgery · 2025Article
- Essential surgery delivery in the Northern Kivu Province of the Democratic Republic of the Congo.BMC surgery · 2024Article
- Article
- Injured and broke: The impacts of the Ghana National Health Insurance Scheme (NHIS) on service delivery and catastrophic health expenditure among seriously injured children.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2021Article
- Knowledge deficits and barriers to performing soft-tissue coverage procedures: An analysis of participants in an orthopaedic surgical skills training course in Mexico.OTA international : the open access journal of orthopaedic trauma · 2019Article
- Barriers to Performing Soft Tissue Reconstruction Procedures among Orthopedic Surgeons in Low- and Middle-income Countries: Results of a Surgical Skills Training Course.Plastic and reconstructive surgery. Global open · 2019Article
- In-Country Training by the Ghana College of Physicians and Surgeons: An Initiative that has Aided Surgeon Retention and Distribution in Ghana.World journal of surgery · 2019Article
- Barriers to Timely Presentation of Patients with Surgical Conditions at Tamale Teaching Hospital in Northern Ghana.World journal of surgery · 2019Article
- Exploring the Relationship Between Surgical Capacity and Output in Ghana: Current Capacity Assessments May Not Tell the Whole Story.World journal of surgery · 2018Article
- Improving Benchmarks for Global Surgery: Nationwide Enumeration of Operations Performed in Ghana.Annals of surgery · 2018Article
- Cost-Effectiveness of a Locally Organized Surgical Outreach Mission: Making a Case for Strengthening Local Non-Governmental Organizations.World journal of surgery · 2017Article
- A Retrospective One-Year Estimation of the Volume and Nature of Surgical and Anaesthetic Services Delivered to the Populations of the Fako Division of the South-West Region of Cameroon: An Urgent Call for Action.World journal of surgery · 2017Article
- Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward.The Journal of bone and joint surgery. American volume · 2016Article
- Consensus recommendations for essential vascular care in low- and middle-income countries.Journal of vascular surgery · 2016Article
- A Model of the Unmet Need for Cleft Lip and Palate Surgery in Low- and Middle-Income Countries.World journal of surgery · 2016Article
- Mapping Population-Level Spatial Access to Essential Surgical Care in Ghana Using Availability of Bellwether Procedures.JAMA surgery · 2016Article
- Barriers to essential surgical care experienced by women in the two northernmost regions of Ghana: a cross-sectional survey.BMC women's health · 2016Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundBeyond resource deficiencies, other barriers to care prevent patients from receiving surgery in low- and middle-income countries (LMICs). This study aimed to develop and pilot a comprehensive, generalizable tool for assessing the barriers to surgical care.
methodsSociodemographic, clinical and 38 questions regarding potential barriers to surgical care were asked during a surgical outreach to two district and one regional hospital in Upper East Region, Ghana. Sites were selected to capture individuals with prolonged unmet surgical needs and represent geographic, socioeconomic, and healthcare development differences. Results were indexed into three dimensions of barriers to care (i.e., 'acceptability,' 'affordability,' and 'accessibility') so that communities could be compared and targeted interventions developed.
resultsThe tool was administered to 148 participants (98 % response rate): Bolgatanga 54 (37 %); Amiah 16 (11 %); and Sandema 78 (52 %). Amiah had the fewest barriers to surgical care (median index 8.3; IQR 7.6-9.3), followed by Sandema (8.2; IQR 5.3-9.2) and Bolgatanga (6.7; IQR 3.9-9.5). Individual dimension scores (i.e., acceptability, affordability, accessibility) ranged from 10.8 to 18 out of 18 possible points. Main factors contributing to low dimension scores were different between communities: Bolgatanga-cost and healthcare navigation; Amiah-social marginalization and poor medical understanding; Sandema-distance to surgically capable facility.
conclusionThis study identified a number of significant barriers, as well as successes for patients' ability and willingness to access surgical care that differed between communities. The tool itself was well accepted, easy to administer and provided valuable data from which targeted interventions can be developed.
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