Open AccessThe Correlation Between Poverty and Access to Essential Surgical Care in Ghana: A Geospatial Analysis
Author(s) -
Tansley Gavin,
Stewart Barclay T.,
Gyedu Adam,
Boakye Godfred,
Lewis Daniel,
Hoogerboord Marius,
Mock Charles
Publication year - 2017
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-016-3765-x
Subject(s) - poverty , health geography , medicine , geospatial analysis , regional variation , population , health informatics , environmental health , geography , socioeconomics , economic growth , public health , nursing , business , health policy , cartography , international health , sociology , advertising , economics
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.