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World Journal of Surgery
Published in: World Journal of Surgery 5/2011

01-05-2011

Systematic Review of Barriers to Surgical Care in Low-Income and Middle-Income Countries

Authors: Caris E. Grimes, Kendra G. Bowman, Christopher M. Dodgion, Christopher B. D. Lavy

Published in: World Journal of Surgery | Issue 5/2011

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Abstract

Background

There is increasing evidence that lack of facilities, equipment, and expertise in district hospitals across many low- and middle-income countries constitutes a major barrier to accessing surgical care. However, what is less clear, is the extent to which people perceive barriers when trying to access surgical care.

Methods

PubMed and EMBASE were searched using key words (“access” and “surgery,” “barrier” and “surgery,” “barrier” and “access”), MeSH headings (“health services availability,” “developing countries,” “rural population”), and the subject heading “health care access.” Articles were included if they were qualitative and applied to illnesses where the treatment is primarily surgical.

Results

Key barriers included difficulty accessing surgical services due to distance, poor roads, and lack of suitable transport; lack of local resources and expertise; direct and indirect costs related to surgical care; and fear of undergoing surgery and anesthesia.

Conclusions

The significance of cultural, financial, and structural barriers pertinent to surgery and their role in wider health care issues are discussed. Immediate action to improve financial and geographic accessibility along with investment in district hospitals is likely to make a significant impact on overcoming access and barrier issues. Further research is needed to identify issues that need to be addressed to close the gap between the care needed and that provided.
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Metadata
Title
Systematic Review of Barriers to Surgical Care in Low-Income and Middle-Income Countries
Authors
Caris E. Grimes
Kendra G. Bowman
Christopher M. Dodgion
Christopher B. D. Lavy
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1010-1

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