van Loenhout, Joris
[UCL]
Delbiso, Tefera Darge
[UCL]
Gupta, Shailvi
Amatya, Kapendra
Kushner, Adam L
Gil Cuesta, Julita
[UCL]
Guha-Sapir, Debarati
[UCL]
BACKGROUND: Various barriers exist that preclude individuals from undergoing surgical care in low-income countries. Our study assessed the main barriers in Nepal, and identified individuals most at risk for not receiving required surgical care. METHODS: A countrywide survey, using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool, was carried out in 2014, surveying 2,695 individuals with a response rate of 97%. Our study used data from a subset, namely individuals who required surgical care in the last twelve months. Data were collected on individual characteristics, transport characteristics, and reasons why individuals did not undergo surgical care. RESULTS: Of the 2,695 individuals surveyed, 207 individuals needed surgical care at least once in the previous 12 months. The main reasons for not undergoing surgery were affordability (n = 42), accessibility (n = 42) and fear/no trust (n = 34). A factor significantly associated with affordability was having a low education (OR = 5.77 of having no education vs. having secondary education). Living in a rural area (OR = 2.59) and a long travel time to a secondary and tertiary health facility (OR = 1.17 and 1.09, respectively) were some of the factors significantly associated with accessibility. Being a woman was significantly associated with fear/no trust (OR = 3.54). CONCLUSIONS: More than half of the individuals who needed surgical care did not undergo surgery due to affordability, accessibility, or fear/no trust. Providing subsidised transport, introducing mobile surgical clinics or organising awareness raising campaigns are measures that could be implemented to overcome these barriers to surgical care.
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Bibliographic reference |
van Loenhout, Joris ; Delbiso, Tefera Darge ; Gupta, Shailvi ; Amatya, Kapendra ; Kushner, Adam L ; et. al. Barriers to surgical care in Nepal. In: BMC Health Services Research, Vol. 17, no.1, p. 72 [1-8] (2017) |
Permanent URL |
http://hdl.handle.net/2078.1/182520 |