title: Assessment of Barriers to Essential Surgical Care in Two Communities in the Upper West Region, Ghana.
abstract: Systematic assessments of individual-and community-level barriers to surgical care (BSC) in low-and middle-income countries that might inform potential interventions are lacking. We used a novel tool to assess BSC systematically during a surgical outreach in two communities in Upper West region, Ghana. Results were scored in three dimensions of barriers to care (acceptability, affordability, and accessibility); higher dimension scores signified less salient barriers. A total index out of 10 was derived. In total, 169 individuals participated in Nadowli (68, 40%) and in Nandom (101, 60%). Nadowli had fewer BSC than Nandom (median index 7.8 vs 7.2; p &lt; .001). Dimension scores ranged from 10.8 to 14.5 out of 18 points. Fear or mistrust of surgical care and stigma were reported more frequently in Nandom (p &lt; .001). Reported barriers were not always the same in each community. Systematically defining barriers to essential surgical care provides an opportunity for planning targeted interventions at the community-level.
authors.forename: Adam
authors.initials: A
authors.lastname: Gyedu
authors.forename: Godfred
authors.initials: G
authors.lastname: Boakye
authors.forename: Charles K
authors.initials: CK
authors.lastname: Dally
authors.forename: Anita Eseenam
authors.initials: AE
authors.lastname: Agbeko
authors.forename: Francis A
authors.initials: FA
authors.lastname: Abantanga
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.forename: Barclay T
authors.initials: BT
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005869:Ghana; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D012737:Sex Factors; D057545:Social Stigma; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000191:economics* / Q000592:standards*; D035502:Trust; D055815:Young Adult