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A geospatial analysis of two-hour surgical access to district hospitals in South Africa

Chu, K.M.
Naidoo, M.
Dell, A.J.
Moultrie, H.
Day, C.
Van Straten, S.
Rayne, S.
Abstract
Background: In a robust health care system, at least 80% of a country's population should be able to access a district hospital that provides surgical care within 2 hours. The objective was to identify the proportion of the population living within 2 hours of a district hospital with surgical capacity in South Africa. Methods: All government hospitals in the country were identified. Surgical district hospitals were defined as district hospitals with a surgical provider, a functional operating theatre, and the provision of at least one caesarean section annually. The proportion of the population within two-hour access was estimated using service area methods. Results: Ninety-eight percent of the population had two-hour access to any government hospital in South Africa. One hundred and thirty-eight of 240 (58%) district hospitals had surgical capacity and 86% of the population had two-hour access to these facilities. Conclusion: Improving equitable surgical access is urgently needed in sub-Saharan Africa. This study demonstrated that in South Africa, just over half of district hospitals had surgical capacity but more than 80% of the population had two-hour access to these facilities. Strengthening district hospital surgical capacity is an international mandate and needed to improve access.
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Date
2020-08-13
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Publisher
Springer Nature
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Keywords
District hospital , Geographic information systems , Global surgery , South Africa , Surgical access , Surgical capacity
Citation
Chu KM, Dell AJ, Moultrie H, Day C, Naidoo M, van Straten S, Rayne S. A geospatial analysis of two-hour surgical access to district hospitals in South Africa. BMC Health Services Research. 2020;20(1):744. doi: 10.1186/s12913-020-05637-0.
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