Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar;41(3):639-643.
doi: 10.1007/s00268-016-3765-x.

The Correlation Between Poverty and Access to Essential Surgical Care in Ghana: A Geospatial Analysis

Gavin Tansley  1   2 , Barclay T Stewart  3   4   5 , Adam Gyedu  6 , Godfred Boakye  4 , Daniel Lewis  7 , Marius Hoogerboord  8 , Charles Mock  3   9   10
Affiliations

The Correlation Between Poverty and Access to Essential Surgical Care in Ghana: A Geospatial Analysis

Gavin Tansley et al. World J Surg. 2017 Mar.

Abstract

Background: Surgical disease burden falls disproportionately on individuals in low- and middle-income countries. These populations are also the least likely to have access to surgical care. Understanding the barriers to access in these populations is therefore necessary to meet the global surgical need.

Methods: Using geospatial methods, this study explores the district-level variation of two access barriers in Ghana: poverty and spatial access to care. National survey data were used to estimate the average total household expenditure (THE) in each district. Estimates of the spatial access to essential surgical care were generated from a cost-distance model based on a recent surgical capacity assessment. Correlations were analyzed using regression and displayed cartographically.

Results: Both THE and spatial access to surgical care were found to have statistically significant regional variation in Ghana (p < 0.001). An inverse relationship was identified between THE and spatial access to essential surgical care (β -5.15 USD, p < 0.001). Poverty and poor spatial access to surgical care were found to co-localize in the northwest of the country.

Conclusions: Multiple barriers to accessing surgical care can coexist within populations. A careful understanding of all access barriers is necessary to identify and target strategies to address unmet surgical need within a given population.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Figures

Fig. 1
Fig. 1
a Scatter plot with fitted line demonstrating an inverse relationship between total household expenditure and travel time to emergency surgical care. b Scatter plot with fitted line demonstrating a positive relationship between total household expenditure and population density. Note population density is expressed on a log scale
Fig. 2
Fig. 2
Bivariate choropleth map demonstrating the colocalization of poverty and poor accessibility of surgical care in Ghana
See this image and copyright information in PMC

References

    1. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015 doi: 10.1016/S0140-6736(15)60160-X. - DOI - PubMed
    1. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569–624. doi: 10.1016/S0140-6736(15)60160-X. - DOI - PubMed
    1. Stewart B, Quansah R, Gyedu A, Ankomah J, Donkor P, et al. Strategic assessment of trauma care capacity in Ghana. World J Surg. 2015;39(10):2428–2440. doi: 10.1007/s00268-015-3132-3. - DOI - PubMed
    1. Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19:127–140. doi: 10.2307/3764310. - DOI - PubMed
    1. Stewart B, Tansley G, Gyedu A, Ofosu A, Donkor P, et al. Mapping access to essential surgical care in Ghana using the availability of Bellwether procedures. JAMA Surg. 2016;151(8):e161239. doi: 10.1001/jamasurg.2016. - DOI - PMC - PubMed