Delayed access to essential surgical care in Uganda: A tertiary multi-center study
Background: Surgery has been largely neglected within global public health despite growing evidence that the overall burden of disease requiring surgical intervention is rapidly growing and affordable access to surgical care can avert many deaths and disabilities. This study assessed the factors inf...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Surgery in Practice and Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266626202300061X |
| _version_ | 1797386815300173824 |
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| author | Emmanuel Adupa Andrew Marvin Kanyike Joshua Mwebembezi Daniel Safari Nteranya Mercy Ndibalema Dissan Matovu Victor Niwenyesiga Smarco Arinda Kenneth Agaba |
| author_facet | Emmanuel Adupa Andrew Marvin Kanyike Joshua Mwebembezi Daniel Safari Nteranya Mercy Ndibalema Dissan Matovu Victor Niwenyesiga Smarco Arinda Kenneth Agaba |
| author_sort | Emmanuel Adupa |
| collection | DOAJ |
| description | Background: Surgery has been largely neglected within global public health despite growing evidence that the overall burden of disease requiring surgical intervention is rapidly growing and affordable access to surgical care can avert many deaths and disabilities. This study assessed the factors influencing delayed access to essential surgical care in Uganda. Methods: A descriptive multi-center cross-sectional survey was carried out in three hospitals designated for major surgeries in Uganda from December 2019 to December 2021 across three regions of the country in a prospective manner. Patients admitted to the hospitals that required surgical intervention were included. Bivariate analysis using the chi-square test or Fischers’ exact test and multivariable logistic regression models to adjust for confounders were carried out. Findings: A total of 635 patients participated in the study of which the majority were males (n = 399, 63%) from the Northern region (n = 347, 54.7%.). Most patients and sought surgical help immediately (n = 406, 63.9%) and were operated on time (n = 402, 63.3%), however only 23.3% (n = 148) were able to reach the hospital for care on time. Caretakers’ hesitancy on the surgical procedure (aOR: 2.41 95% CI: 1.07 – 5.43; p = 0.035), hospital inaccessibility (aOR: 5.35 95% CI: 1.82 – 5.75; p = 0.002), and delayed surgical procedure performance (aOR: 6.37 95% CI: 2.64 – 5.34; p<0.001) contributed to surgical delays among other factors. Interpretation: All three factors contribute to surgical delay but most significantly access to hospital. Several socioeconomic factors like education, long distances, and poverty interplay in a complex web to hamper access to essential surgical care. |
| first_indexed | 2024-03-08T22:14:50Z |
| format | Article |
| id | doaj.art-fda0feab0b5f463195509c95e4e83096 |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-08T22:14:50Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-fda0feab0b5f463195509c95e4e830962023-12-19T04:17:24ZengElsevierSurgery in Practice and Science2666-26202023-12-0115100215Delayed access to essential surgical care in Uganda: A tertiary multi-center studyEmmanuel Adupa0Andrew Marvin Kanyike1Joshua Mwebembezi2Daniel Safari Nteranya3Mercy Ndibalema4Dissan Matovu5Victor Niwenyesiga6Smarco Arinda7Kenneth Agaba8Department of Obstetrics & Gynecology, St. Mary's Hospital Lacor, Gulu, Uganda; Department of Obstetrics & Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Corresponding author at: Department of Obstetrics & Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.Department of Surgery, Mengo Hospital, Kampala, UgandaDepartment of Internal Medicine, Kabale Regional Referral Hospital, Kabale, UgandaDepartment of Surgery, University of Bukavu, DRC; Research Department, Association of Future African Neurosurgeons, Yaoundé, CameroonDepartment of Internal Medicine, Kabale Regional Referral Hospital, Kabale, UgandaDepartment of Surgery, Rubaga Hospital, Kampala, UgandaDepartment of Surgery, Hoima Regional Referral Hospital, Hoima, UgandaDepartment of Obstetrics & Gynecology, Ishaka Adventist hospital, Bushenyi, UgandaDepartment of Surgery, Fort Portal Regional Referral Hospital, Fort Portal, UgandaBackground: Surgery has been largely neglected within global public health despite growing evidence that the overall burden of disease requiring surgical intervention is rapidly growing and affordable access to surgical care can avert many deaths and disabilities. This study assessed the factors influencing delayed access to essential surgical care in Uganda. Methods: A descriptive multi-center cross-sectional survey was carried out in three hospitals designated for major surgeries in Uganda from December 2019 to December 2021 across three regions of the country in a prospective manner. Patients admitted to the hospitals that required surgical intervention were included. Bivariate analysis using the chi-square test or Fischers’ exact test and multivariable logistic regression models to adjust for confounders were carried out. Findings: A total of 635 patients participated in the study of which the majority were males (n = 399, 63%) from the Northern region (n = 347, 54.7%.). Most patients and sought surgical help immediately (n = 406, 63.9%) and were operated on time (n = 402, 63.3%), however only 23.3% (n = 148) were able to reach the hospital for care on time. Caretakers’ hesitancy on the surgical procedure (aOR: 2.41 95% CI: 1.07 – 5.43; p = 0.035), hospital inaccessibility (aOR: 5.35 95% CI: 1.82 – 5.75; p = 0.002), and delayed surgical procedure performance (aOR: 6.37 95% CI: 2.64 – 5.34; p<0.001) contributed to surgical delays among other factors. Interpretation: All three factors contribute to surgical delay but most significantly access to hospital. Several socioeconomic factors like education, long distances, and poverty interplay in a complex web to hamper access to essential surgical care.http://www.sciencedirect.com/science/article/pii/S266626202300061XEssential surgical careDelayed accessUganda |
| spellingShingle | Emmanuel Adupa Andrew Marvin Kanyike Joshua Mwebembezi Daniel Safari Nteranya Mercy Ndibalema Dissan Matovu Victor Niwenyesiga Smarco Arinda Kenneth Agaba Delayed access to essential surgical care in Uganda: A tertiary multi-center study Surgery in Practice and Science Essential surgical care Delayed access Uganda |
| title | Delayed access to essential surgical care in Uganda: A tertiary multi-center study |
| title_full | Delayed access to essential surgical care in Uganda: A tertiary multi-center study |
| title_fullStr | Delayed access to essential surgical care in Uganda: A tertiary multi-center study |
| title_full_unstemmed | Delayed access to essential surgical care in Uganda: A tertiary multi-center study |
| title_short | Delayed access to essential surgical care in Uganda: A tertiary multi-center study |
| title_sort | delayed access to essential surgical care in uganda a tertiary multi center study |
| topic | Essential surgical care Delayed access Uganda |
| url | http://www.sciencedirect.com/science/article/pii/S266626202300061X |
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