Barriers to essential surgical care experienced by women in the two northernmost regions of Ghana: a cross-sectional survey

BMC Women's Health

Research Article

Barclay Stewart¹  Adam Gyedu²  Francis Abantanga²  Shailvi Gupta³  Anita Eseenam Agbeko⁴  Godfred Boakye⁵  Easmon Otupiri⁵  Adam Kushner⁶ 

[1] Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Surgery, University of Washington, Seattle, WA, USA;Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana;Department of Surgery, University of California, San Francisco, CA, USA;Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana;School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Surgeons OverSeas (SOS), New York, NY, USA;Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Department of Surgery, Columbia University, New York, NY, USA;

关键词: Barriers;    Women;    Essential surgical care;    Ghana;    LMIC;   

DOI  :  10.1186/s12905-016-0308-4

 received in 2015-09-21, accepted in 2016-05-21,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWomen in developing countries might experience certain barriers to care more frequently than men. We aimed to describe barriers to essential surgical care that women face in five communities in Ghana.MethodsQuestions regarding potential barriers were asked during surgical outreaches to five communities in the northernmost regions of Ghana. Responses were scored in three dimensions from 0 to 18 (i.e., ‘acceptability,’ ‘affordability,’ and ‘accessibility’; 18 implied no barriers). A barrier to care index out of 10 was derived (10 implied no barriers). An open-ended question to elicit gender-specific barriers was also asked.ResultsOf the 320 participants approached, 315 responded (response rate 98 %); 149 were women (47 %). Women had a slightly lower barriers to surgical care index (median index 7.4; IQR 3.9–9.1) than men (7.9; IQR 3.9–9.4; p = 0.002). Compared with men, women had lower accessibility and acceptability dimension scores (14.4/18 vs 14.4/18; p = 0.001 and 13.5/18 vs 14/18; p = 0.05, respectively), but similar affordability scores (13.5/18 vs 13.5/18; p = 0.13). Factors contributing to low dimension scores among women included fear of anesthesia, lack of social support, and difficulty navigating healthcare, as well as lack of hospital privacy and confidentiality.ConclusionWomen had a slightly lower barriers to surgical care index than men, which may indicate greater barriers to surgical care. However, the actual significance of this difference is not yet known. Community-level education regarding the safety and benefits of essential surgical care is needed. Additionally, healthcare facilities must ensure a private and confidential care environment. These interventions might ameliorate some barriers to essential surgical care for women in Ghana, as well as other LMICs more broadly.

【 授权许可】

CC BY   
© The Author(s). 2016