Abstract
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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0308-4) contains supplementary material, which is available to authorized users.
Highlights
Women in developing countries might experience certain barriers to care more frequently than men
Up to five billion people, most of whom live in low- and middle-income countries (LMICs), do not have access to essential surgical care as defined by the world bank’s Disease Control Priorities, third edition (DCP-3) [2]
We aimed to describe the barriers to surgical care that women face in five deprived communities in northern Ghana and compare them to the barriers faced by men
Summary
Women in developing countries might experience certain barriers to care more frequently than men. Essential surgical care consists of surgical decision-making and procedures that address high-burden conditions, are cost effective, and are feasible to implement Given this gap between the burden of surgical conditions and the availability of surgical care services, LMICs have high prevalence of unmet surgical need - a situation where a person has a condition treatable by essential surgical care or is in need of a surgical consultation and is not able to access required care [3, 4]. This is true even for common conditions (i.e. skin and soft tissue masses, breast and gynecologic problems) [3, 5].
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