Chu, K.M.Naidoo, M.Dell, A.J.Moultrie, H.Day, C.Van Straten, S.Rayne, S.2024-05-052024-05-052020-08-13Chu 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/s12913-020-05637-0.10.1186/s12913-020-05637-0https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05637-0https://doi.org/10.1186/s12913-020-05637-0https://hdl.handle.net/11288/596063Background: 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.enAttribution 3.0 United Stateshttp://creativecommons.org/licenses/by/3.0/us/District hospitalGeographic information systemsGlobal surgerySouth AfricaSurgical accessSurgical capacityArticleBMC Health Services Research