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. 2022 Jul 30;22(1):973.
doi: 10.1186/s12913-022-08357-9.

Access to surgical care in Ethiopia: a cross-sectional retrospective data review

Berhane Redae Meshesha  1   2   3 , Manuel Kassaye Sibhatu  2   4 , Hassen Mohammed Beshir  1 , Wuletaw Chane Zewude  3 , Desalegn Bekele Taye  1 , Edlawit Mesfin Getachew  5 , Kassa Haile Merga  5 , Tsegaye Hailu Kumssa  5 , Endawoke Amsalu Alemayue  5 , Akililu Alemu Ashuro  5 , Mulatu Biru Shagre  5   6 , Senedu Bekele Gebreegziabher  7
Affiliations

Access to surgical care in Ethiopia: a cross-sectional retrospective data review

Berhane Redae Meshesha et al. BMC Health Serv Res. .

Abstract

Background: Access to emergency and essential surgical care is still unmet and accessibility is disproportionately inequitable in Ethiopia and other low-and middle-income countries. The aim of this study was to assess surgical care access in terms of capability, capacity, and timeliness of care in different levels of health care in Ethiopia.

Methods: A cross-sectional study with retrospective data review was conducted in 172 health facilities from December 30, 2020 to June 10, 2021. Descriptive statistics such as median with interquartile range and proportion were computed using STATA Version 15 statistical software.

Results: Within a 90-day interval of the study period, 69,717 major and minor surgeries, and 33,052 bellwether procedures were performed, and major surgeries accounted for 58% of the surgeries. About 1.6%, 23.56%, 25.34%, and 32.2% of both major and minor, and 3.1%, 12.8%, 27.6%, and 45.3% of bellwether procedures were performed in health center OR blocks, primary, general, and specialized hospitals, respectively. Private hospitals performed 17.33% of major and minor and 11.2% of bellwether procedures for the period. The average pre-admission waiting time for surgical patients in primary, general, and specialized hospitals was 9.68, 37.6, and 35.9 days, respectively, whereas, in private hospitals, the average pre-admission waiting time was 1.42 days. On average, surgical patients traveled 5 Hrs, 11 Hrs, 28.4 Hrs, and 21.3 Hrs to access surgical services in primary, general, specialized, and private hospitals, respectively. The surgical workforce to the population served ratio was 7.5, 1.15, and 1.31/100.000 population in primary, specialized and general hospitals, respectively.

Conclusion: Most surgical procedures were performed in specialized hospitals, indicating that there is a burden in these health facilities. The pre-admission waiting time for surgical patients was long in higher-level public hospitals. Surgical patients traveled a long distance to access surgical service in higher level hospitals. The ratio of surgical workforce per 100,000 population served was low in all levels of public health facilities in general, and in higher level hospitals in particular. Efforts should therefore be made to strengthen all levels of the health system and improve surgical care access in terms of capacity, capability, and timeliness in the country.

Keywords: Access; Cross-sectional; Ethiopia; Retrospective data; Surgical care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The pie chart describes the proportion of surgical patients refereed to other health care facilities in a 90-day interval, from September 2020 to May 2021, disaggregated by level of health care facilities, Ethiopia
Fig. 2
Fig. 2
The bar graph illustrates common reasons for referral of patients for surgical intervention to other health care facilities in a 90-day interval, from September 2020 to May 2021, Ethiopia
See this image and copyright information in PMC

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