AB021. Geospatial mapping of two-hour access to timely essential surgery in the Philippines
Abstract

AB021. Geospatial mapping of two-hour access to timely essential surgery in the Philippines

Xuxin Lim1,2, Madhumitha Ayyappan3, Ma Wai Wai Zaw4, Nikita Kanumoory Mandyam5, Hui Xiang Chia5, Don Eliseo Lucero-Prisno III6,7

1Department of Paediatric Surgery, KK Women’s and Children’s Hospital, Singapore, Singapore; 2Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; 3Department of Medical Anthropology, Yale-NUS College, Singapore, Singapore; 4Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore; 5National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore; 6Faculty of Management and Development Studies, University of Philippines (Open University), Los Banos, Laguna, Philippines; 7World Surgical Foundation, Manila, Philippines

Correspondence to: Xuxin Lim, MBChB, MSc, MRCSEd, DPhil. Department of Paediatric Surgery, KK Women’s and Children’s Hospital, Singapore, Singapore; Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave, Boston, MA 02115, USA. Email: Meghan_lim@hms.harvard.edu.

Background: Timely access to safe and affordable surgery is essential for universal health coverage. To date, there are no studies evaluating the 2-hour access to Bellwether procedures (Caesarean section, laparotomy, open fracture management) in the Philippines. Thus, the objectives of this study are firstly, to measure the proportion of the population able to reach a Bellwether hospital within 2 hours in the Philippines and secondly, to identify areas in the country with the most surgically underserved populations.

Methods: All Philippines public hospitals with Bellwether capacities were identified from the Ministry of Health website. The service area tool in ArcGIS Pro was used to determine the population within a two-hour drive time of a Bellwether facility. Finally, suitability modelling was done to identify potential future sites for a surgical facility that targets the most underserved regions in the Philippines.

Results: A total of 428 Bellwether capable hospitals were identified. 85.1% of the population lived within 2 hours of one of these facilities. However, seven regions had less than 80% of its population living within 2 hours of a Bellwether capable facility—Bicol, Eastern Visayas, Zamboanga, Cordillera, Autonomous region of Muslim Mindanao, Caraga and Mimaropa. Suitability analysis identified four regions—Caraga, Mimaropa, Calabarzon and Zamboanga—which are ideal locations to build a new hospital with surgical capacity.

Conclusions: The Philippines is a country which provides good access to essential and emergency surgical services to its population. More than 80% of its population can access Bellwether procedures within 2 hours. However, regional disparities in terms of access still need to be addressed. Surgical capacity needs to be improved in regions which do not meet the Lancet Commission of Global Surgery (LCoGS) indicator target for 2-hour access to essential surgery of at least 80%.

Keywords: Geospatial mapping; access to surgery; Philippines; Bellwether procedures; global surgery

Acknowledgments

The full version of this paper was published in the BMJ Open (https://doi.org/10.1136/bmjopen-2023-074521).

Funding: The study was funded by the SDGHI and SSHPSH Joint Funding Initiative on Global Health Research in Asia, which was administered by Saw Swee Hock School of Public Health, Singapore (grant No. A-0006403-00-00).

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jphe.amegroups.com/article/view/10.21037/jphe-2023-apru-ab021/coif). Dr. M.W.W.Z. reported that the SDGHI and SSHPSH Joint Funding Initiative on Global Health Research in Asia, which is administered by Saw Swee Hock School of Public Health, Singapore supported the above-mentioned manuscript and Dr. M.W.W.Z.’s attendance of APRU Global Health Conference 2023. Dr. M.W.W.Z. reported medical stocks (Abbott Labs, Astrazeneca, Becton Dickinson, Edwards Lifesciences, Intuitive Surg, Johnson & Johnson, Medtronic) procured personally and independent of manuscript work. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/jphe-2023-apru-ab021
Cite this abstract as: Lim X, Ayyappan M, Zaw MWW, Mandyam NK, Chia HX, Lucero-Prisno DE 3rd. AB021. Geospatial mapping of two-hour access to timely essential surgery in the Philippines. J Public Health Emerg 2024;8:AB021.

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