A81 Emergency Transport experiences from Sub-Saharan Africa: public involvement in transport innovations to improve access to healthcare

2015 ◽  
Vol 2 (2) ◽  
pp. S47 ◽  
Author(s):  
Ana Luisa Silva ◽  
Silvia Poggioli
Keyword(s):  
Public Involvement ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Emergency Transport ◽  
Sub Saharan ◽  
Improve Access

scholarly journals Mapping physical access to healthcare for older adults in sub-Saharan Africa: A cross-sectional analysis with implications for the COVID-19 response

2020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Travel Time ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Travel Times ◽  
Healthcare Resources ◽  
Healthcare Facilities ◽  
Sub Saharan ◽  
Physical Access

Background: SARS-CoV-2, the virus causing coronavirus disease 2019 (COVID-19), is rapidly spreading across sub-Saharan Africa (SSA). Hospital-based care for COVID-19 is particularly often needed among older adults. However, a key barrier to accessing hospital care in SSA is travel time. To inform the geographic targeting of additional healthcare resources, this study aimed to determine the estimated travel time at a 1km x 1km resolution to the nearest hospital and to the nearest healthcare facility of any type for adults aged 60 years and older in SSA. Methods: We assembled a unique dataset on healthcare facilities' geolocation, separately for hospitals and any type of healthcare facility (including primary care facilities) and including both private- and public-sector facilities, using data from the OpenStreetMap project and the KEMRI Wellcome Trust Programme. Population data at a 1km x 1km resolution was obtained from WorldPop. We estimated travel time to the nearest healthcare facility for each 1km x 1km raster using a cost-distance algorithm. Findings: 9.6% (95% CI: 5.2% - 16.9%) of adults aged 60 and older years had an estimated travel time to the nearest hospital of longer than six hours, varying from 0.0% (95% CI: 0.0% - 3.7%) in Burundi and The Gambia, to 40.9% (95% CI: 31.8% - 50.7%) in Sudan. 11.2% (95% CI: 6.4% - 18.9%) of adults aged 60 years and older had an estimated travel time to the nearest healthcare facility of any type (whether primary or secondary/tertiary care) of longer than three hours, with a range of 0.1% (95% CI: 0.0% - 3.8%) in Burundi to 55.5% (95% CI: 52.8% - 64.9%) in Sudan. Most countries in SSA contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of more than 12 hours and to the nearest healthcare facility of any type of more than six hours. The median travel time to the nearest hospital for the fifth of adults aged 60 and older years with the longest travel times was 348 minutes (IQR: 240 - 576 minutes) for the entire SSA population, ranging from 41 minutes (IQR: 34 - 54 minutes) in Burundi to 1,655 minutes (IQR: 1065 - 2440 minutes) in Gabon. Interpretation: Our high-resolution maps of estimated travel times to both hospitals and healthcare facilities of any type can be used by policymakers and non-governmental organizations to help target additional healthcare resources, such as new make-shift hospitals or transport programs to existing healthcare facilities, to older adults with the least physical access to care. In addition, this analysis shows precisely where population groups are located that are particularly likely to under-report COVID-19 symptoms because of low physical access to healthcare facilities. Beyond the COVID-19 response, this study can inform countries' efforts to improve care for conditions that are common among older adults, such as chronic non-communicable diseases.

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

2020 ◽  
Author(s):  
Kathryn Chu ◽  
Angela J Dell ◽  
Harry Moultrie ◽  
Candy Day ◽  
Megan Naidoo ◽  
...  
Keyword(s):  
South Africa ◽  
District Hospital ◽  
Surgical Care ◽  
Sub Saharan Africa ◽  
Surgical Capacity ◽  
Surgical Access ◽  
District Hospitals ◽  
Government Hospitals ◽  
Sub Saharan ◽  
Improve Access

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 two hours. The objective was to identify the proportion of the population living within two 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.

scholarly journals Sociodemographic Inequalities in Health Insurance Ownership among Women in Selected Francophone Countries in Sub-Saharan Africa

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yiting Wang ◽  
Xuhui Wang ◽  
Lu Ji ◽  
Rui Huang
Keyword(s):  
Health Insurance ◽  
Rural Women ◽  
Rural Areas ◽  
Household Wealth ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Universal Healthcare ◽  
Explanatory Factors ◽  
Sub Saharan

In sub-Saharan Africa, improving equitable access to healthcare remains a major challenge for public health systems. Health policymakers encourage the adoption of health insurance schemes to promote universal healthcare. Nonetheless, progress towards this goal remains suboptimal due to inequalities health insurance ownership especially among women. In this study, we aimed to explore the sociodemographic factors contributing to health insurance ownership among women in selected francophone countries in sub-Saharan Africa. Methods. This study is based on cross-sectional data obtained from Demographic and Health Surveys on five countries including Benin ( n = 13,407 ), Madagascar ( n = 12,448 ), Mali ( n = 10,326 ), Niger ( n = 12,558 ), and Togo ( n = 6,979 ). The explanatory factors included participant age, marital status, type of residency, education, household wealth quantile, employment stats, and access to electronic media. Associations between health insurance ownership and the explanatory factors were analyzed using multivariate regression analysis, and effect sizes were reported in terms in average marginal effects (AMEs). Results. The highest percentage of insurance ownership was observed for Togo (3.31%), followed by Madagascar (2.23%) and Mali (2.2%). After stratifying by place of residency, the percentages were found to be significantly lower in the rural areas for all countries, with the most noticeable difference observed for Niger (7.73% in urban vs. 0.54% in rural women). Higher levels of education and wealth quantile were positively associated with insurance ownership in all five countries. In the pooled sample, women in the higher education category had higher likelihood of having an insurance: Benin ( AME = 1.18 ; 95% CI = 1.10 , 1.27), Madagascar ( AME = 1.10 ; 95% CI = 1.05 , 1.15), Mali ( AME = 1.14 ; 95% CI = 1.04 , 1.24), Niger ( AME = 1.13 ; 95% CI = 1.07 , 1.21), and Togo ( AME = 1.17 ; 95% CI = 1.09 , 1.26). Regarding wealth status, women from the households in the highest wealth quantile had 4% higher likelihood of having insurance in Benin and Mali and 6% higher likelihood in Madagascar and Togo. Conclusions. Percentage of women who reported having health insurance was noticeably low in all five countries. As indicated by the multivariate analyses, the actual situation is likely to be even worse due to significant socioeconomic inequalities in the distribution of women having an insurance plan. Increasing women’s access to healthcare is an urgent priority for population health promotion in these countries, and therefore, addressing the entrenched sociodemographic disparities should be given urgent policy attention in an effort to strengthen universal healthcare-related goals.

scholarly journals Understanding surgical care delivery in Sub-Saharan Africa: a cross-sectional analysis of surgical volume, operations, and financing at a tertiary referral hospital in rural Tanzania

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Praveen Paul Rajaguru ◽  
Mubashir Alavi Jusabani ◽  
Honest Massawe ◽  
Rogers Temu ◽  
Neil Perry Sheth
Keyword(s):  
Surgical Care ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Surgical Volume ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Emergency Procedures ◽  
Sub Saharan ◽  
Improve Access ◽  
Main Operating

Abstract Background Access to surgical care in Low- and Middle-Income Countries (LMICs) such as Tanzania is extremely limited. Northern Tanzania is served by a single tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC). The surgical volumes, workflow, and payment mechanisms in this region have not been characterized. Understanding these factors is critical in expanding access to healthcare. The authors sought to evaluate the operations and financing of the main operating theaters at KCMC in Sub-Saharan Africa. Methods The 2018 case volume and specialty distribution (general, orthopaedic, and gynecology) in the main operating theaters at KCMC was retrieved through retrospective review of operating report books. Detailed workflow (i.e. planned and cancelled cases, lengths of procedures, lengths of operating days) and financing data (patient payment methods) from the five KCMC operating theater logs were retrospectively reviewed for the available five-month period of March 2018 to July 2018. Descriptive statistics and statistical analysis were performed. Results In 2018, the main operating theaters at KCMC performed 3817 total procedures, with elective procedures (2385) outnumbering emergency procedures (1432). General surgery (1927) was the most operated specialty, followed by orthopaedics (1371) and gynecology (519). In the five-month subset analysis period, just 54.6% of planned operating days were fully completed. There were 238 cancellations (20.8% of planned operations). Time constraints (31.1%, 74 cases) was the largest reason; lack of patient payment accounted for as many cancellations as unavailable equipment (6.3%, 15 cases each). Financing for elective theater cases included insurance 45.5% (418 patients), and cash 48.4% (445 patients). Conclusion While surgical volume is high, there are non-physical inefficiencies in the system that can be addressed to reduce cancellations and improve capacity. Improving physical resources is not enough to improve access to care in this region, and likely in many LMIC settings. Patient financing and workflow will be critical considerations to truly improve access to surgical care.

Interfacing Indigenous Knowledge Systems and Access to Healthcare in SADC through the Millennium Development Goals

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Amos Saurombe
Keyword(s):  
Indigenous Knowledge ◽  
Millennium Development Goals ◽  
Access To Healthcare ◽  
Knowledge Systems ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Poor Countries ◽  
Indigenous Knowledge Systems ◽  
Development Goals ◽  
Sub Saharan

There are eight health-related Millennium Development Goals (MDGs), the mandate of which is to ensure access to affordable healthcare for poor countries, especially in Africa. These MDGs were supposed to be reached by 2015, but six years have now passed with little success being realised. The cost of affordable medicines remains the main predicament for poor African countries. The focus of this paper is limited to the poor countries of the Southern African Development Community (SADC), a part of sub-Saharan Africa. I have previously written on other measures that have been employed to improve access to medicine, for example pooled procurement used by a number of SADC countries. Unfortunately the vast rural nature of SADC member states makes it prohibitively impossible to reach every citizen, let alone convince them of the usefulness of Western healthcare. A number of scholars have written about southern Africa’s riches in the area of Indigenous Knowledge Systems (IKS) that directly relate to healthcare. It is thus the objective of this paper to argue that both efforts of using IKS and the modern healthcare system can complement each other in the quest for the realisation of better healthcare and quality of life for the citizens of southern Africa. This paper starts with a motivation to indicate why IKS and access to healthcare are related. An analysis of the eight related MDGs follows as a way of measuring how far these have been realised post the anticipated date in 2015. In this analysis, it is critical to unearth how IKS can be used in the realisation of solutions to these shortcomings.

scholarly journals Inequitable access to healthcare in Africa: reconceptualising the “accountability for reasonableness framework” to reflect indigenous principles

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Samuel J. Ujewe ◽  
Werdie C. van Staden
Keyword(s):  
Health Equity ◽  
John Rawls ◽  
The United States ◽  
Access To Healthcare ◽  
Ethical Principle ◽  
Sub Saharan Africa ◽  
Accountability For Reasonableness ◽  
Fair Equality Of Opportunity ◽  
Sub Saharan ◽  
Communal Responsibility

Abstract Background The “Accountability for Reasonableness” (A4R) framework has been widely adopted in working towards equity in health for sub-Saharan Africa (SAA). Its suitability for equitable health policy in Africa hinges, at least in part, on its considerable successes in the United States and it being among the most comprehensive ethical approaches in addressing inequitable access to healthcare. Yet, the conceptual match is yet to be examined between A4R and communal responsibility as a common fundamental ethic in SAA. Methodology A4R and its applications toward health equity in sub-Saharan Africa were conceptually examined by considering the WHO’s “3-by-5” and the REACT projects for their accounting for the communal responsibility ethic in pursuit of health equity. Results Some of the challenges that these projects encountered may be ascribed to an incongruity between the underpinning ethical principle of A4R and the communitarian ethical principle dominant in sub-Saharan Africa. These are respectively the fair equality of opportunity principle derived from John Rawls’ theory, and the African communal responsibility principle. Conclusion A health equity framework informed by the African communal responsibility principle should enhance suitability for SAA contexts, generating impetus from within Africa alongside the affordances of A4R.

scholarly journals Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

2019 ◽  
Vol 12 (1) ◽  
pp. 504-514 ◽  
Author(s):  
Azuh Dominic ◽  
Adeyemi Ogundipe ◽  
Oluwatomisin Ogundipe
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Generalized Method Of Moments ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Service Availability ◽  
Healthcare Facilities ◽  
Sub Saharan

Background: The study examined the socio-economic determinants of women access to healthcare services in Sub-Saharan Africa for the period 1995-2015. Methods: The study adopted the dynamic panel model and estimated it using the System Generalized Method of Moments in a bid to overcome the endogeneity problem inherent in the model of study. Result: The study harmonized the theoretical strands in the literature by describing the measure of access determinants as three main components; i. Health service availability, ii. Health service utilization and iii. Health service decision. Conclusion: The indicators of health service availability such as community health workers, physicians, nurses and midwives and hospital beds improve women's access to healthcare facilities in Africa. Also, health service utilization indicators such as population density worsen the quality of healthcare services available to women while electricity access and private health expenditure enhance women’s access to quality healthcare delivery. Health service decision indicators such as female bank account ownership, female labour force participation, attainment of basic education and female household headship were important in enhancing women's access to healthcare facilities. Generally, women's health outcomes were more responsive to health service utilization; implying that service utilization is an important proof of healthcare access in Africa.

Open Access and the Future of Scholarly Communication in Sub-Saharan Africa

2021 ◽  
pp. 205-220
Author(s):  
Tuesday Bwalya ◽  
Akakandelwa Akakandelwa
Keyword(s):  
Open Access ◽  
Scholarly Communication ◽  
Information Resources ◽  
Sub Saharan Africa ◽  
Open Access Publishing ◽  
The Future ◽  
History Of ◽  
Research Findings ◽  
Sub Saharan ◽  
Improve Access

The concept of open access has opened up access to scholarly communication. Academia today can publish and have access to a cocktail of information resources without restrictions and without paying anything. This chapter seeks to explain open access to scholarly communication and its future in Sub-Saharan Africa. The chapter begins by explaining the concept of open access, various forms of open access publishing, benefits of open access, and a brief history of open access to scholarly communication in Sub-Saharan Africa. The chapter also highlights some notable open access initiatives that have been implemented in Sub-Saharan Africa in the quest to improve access to scientific research findings in order to accelerate economic development. Furthermore, the chapter catalogues some challenges being encountered in the promotion of open access in Sub-Saharan Africa. Lastly, the chapter predicts the future of open access to scholarly communication in Sub-Saharan Africa, based on the current happenings in this sector.

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