SURGICAL ACCESS IN ETHIOPIA: A GEOSPATIAL MODELING STUDY  coikonte@mcw.edu

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SURGICAL ACCESS IN ETHIOPIA: A GEOSPATIAL MODELING STUDY 

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Chris Dodgion cdodgion@mcw.edu Medical College of Wisconsin Milwaukee United States

Wei Xu weixu@mcw.edu Medical College of Wisconsin Milwaukee United States

Katherine Iverson kiverson@mcw.edu Medical College of Wisconsin Milwaukee United States

United States

Oral or Poster

Access to essential surgical care varies significantly worldwide, particularly in low- and middle-income countries (LMICs). Prior studies estimate that patients in Ethiopia travel between 5 and 28.4 hours to reach surgical services. Our study determined the geographic accessibility of surgical facilities in Ethiopia using nationally available data to determine the proportion of the population within a two-hour travel time.

The coordinates of 839 hospitals reporting surgical volumes from the Ethiopian Federal Ministry of Health (FMOH) were geocoded and combined with geospatial data on road networks, elevation, land cover, population density, and travel barriers. Three travel scenarios were modeled: (1) driving+walking, (2) bicycling/horse + walking, and (3) walking only. Population coverage was analyzed at 30-minute, 1-hour, and 2-hour travel time thresholds.

Nationwide, 70.9% Ethiopia’s population had access to a surgical facility within 2 h under Scenario 1, compared to 55.4% and 25.1% for Scenarios 2 and 3, respectively. Regional disparities were significant: under Scenario 1, 99.6% of Harari’s population had access within 2 h, while only 25.9% did in Somali. For walking only (Scenario 3), access ranged from 10.0% in Somali to 95.2% in Addis Ababa.

Following the launch of Ethiopia’s Saving Lives through the Safe Surgery (SaLTS) initiative in 2015, access to surgical care, improved from (39.6%) to (70.9%), by 2025. However, rural access to surgery remains a challenge, necessitating targeted interventions and regional implementation strategies to enhance surgical accessibility across sub-Saharan African countries.