Assessment of Barriers to Essential Surgical Care in Two Communities in the Upper West Region, Ghana

作者：Gyedu Adam; Boakye Godfred; Dally Charles K; Agbeko Anita Eseenam; Abantanga Francis A; Kushner Adam L; Stewart Barclay T

来源：Journal of Health Care for the Poor and Underserved, 2017, 28(1): 175-190.

DOI：10.1353/hpu.2017.0016

• Barriers
• essential surgical care
• Ghana

Systematic assessments of individual- and community-level barriers to surgical care (BSC) in low- and middle-income countries that might inform potential interventions are lacking. We used a novel tool to assess BSC systematically during a surgical outreach in two communities in Upper West region, Ghana. Results were scored in three dimensions of barriers to care (acceptability, affordability, and accessibility); higher dimension scores signified less salient barriers. A total index out of 10 was derived. In total, 169 individuals participated in Nadowli (68, 40%) and in Nandom (101, 60%). Nadowli had fewer BSC than Nandom (median index 7.8 vs 7.2; p <.001). Dimension scores ranged from 10.8 to 14.5 out of 18 points. Fear or mistrust of surgical care and stigma were reported more frequently in Nandom (p <.001). Reported barriers were not always the same in each community. Systematically defining barriers to essential surgical care provides an opportunity for planning targeted interventions at the community-level.

• 出版日期2017-2