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01-02-2017 | Original Scientific Report

Geospatial Analysis of Unmet Surgical Need in Uganda: An Analysis of SOSAS Survey Data

Authors: S. Harrison Farber, Joao Ricardo Nickenig Vissoci, Tu M. Tran, Anthony T. Fuller, Elissa K. Butler, Luciano Andrade, Catherine Staton, Fredrick Makumbi, Samuel Luboga, Christine Muhumuza, Didacus B. Namanya, Jeffrey G. Chipman, Moses Galukande, Michael M. Haglund

Published in: World Journal of Surgery | Issue 2/2017

Abstract

Background

Globally, a staggering five billion people lack access to adequate surgical care. Sub-Saharan Africa represents one of the regions of greatest need. We sought to understand how geographic factors related to unmet surgical need (USN) in Uganda.

Methods

We performed a geographic information system analysis of a nationwide survey on surgical conditions performed in 105 enumeration areas (EAs) representing the national population. At the district level, we determined the spatial autocorrelation of the following study variables: prevalence of USN, hub distance (distance from EA to the nearest surgical center), area of coverage (geographic catchment area of each center), tertiary facility transport time (average respondent-reported travel time), and care availability (rate of hospital beds by population and by district). We then used local indicators of spatial association (LISA) and spatial regression to identify any significant clustering of these study variables among the districts.

Results

The survey enumerated 4248 individuals. The prevalence of USN varied from 2.0–45 %. The USN prevalence was highest in the Northern and Western Regions. Moran’s I bivariate analysis indicated a positive correlation between USN and hub distance (p = 0.03), area of coverage (p = 0.02), and facility transport time (p = 0.03). These associations were consistent nationally. The LISA analysis showed a high degree of clustering among sets of districts in the Northern Sub-Region.

Conclusions

This study demonstrates a statistically significant association between USN and the geographic variables examined. We have identified the Northern Sub-Region as the highest priority areas for financial investment to reduce this unmet surgical disease burden.

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Title: Geospatial Analysis of Unmet Surgical Need in Uganda: An Analysis of SOSAS Survey Data
Authors: S. Harrison Farber
Joao Ricardo Nickenig Vissoci
Tu M. Tran
Anthony T. Fuller
Elissa K. Butler
Luciano Andrade
Catherine Staton
Fredrick Makumbi
Samuel Luboga
Christine Muhumuza
Didacus B. Namanya
Jeffrey G. Chipman
Moses Galukande
Michael M. Haglund
Publication date: 01-02-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 2/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3689-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Geospatial Analysis of Unmet Surgical Need in Uganda: An Analysis of SOSAS Survey Data

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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