Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums
Objective The study examines the geographic accessibility of Comprehensive Emergency Obstetric Care (CEmONC) among women residing in the slums of Dakar.Design The study is a cross-sectional geographic analysis of caesarean care utilisation in health facilities offering the service in Dakar.Setting T...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/3/e088606.full |
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| author | Winfred Dotse-Gborgbortsi Cheikh Faye Arsene Brunelle Sandie Fadima Yaya Bocoum El Hadji Malick Sylla Ndeye Awa Fall Barrel Sow Gueye Diarra Bousso Senghor Birane Cissé Ibrahima Ousmane Sy |
| author_facet | Winfred Dotse-Gborgbortsi Cheikh Faye Arsene Brunelle Sandie Fadima Yaya Bocoum El Hadji Malick Sylla Ndeye Awa Fall Barrel Sow Gueye Diarra Bousso Senghor Birane Cissé Ibrahima Ousmane Sy |
| author_sort | Winfred Dotse-Gborgbortsi |
| collection | DOAJ |
| description | Objective The study examines the geographic accessibility of Comprehensive Emergency Obstetric Care (CEmONC) among women residing in the slums of Dakar.Design The study is a cross-sectional geographic analysis of caesarean care utilisation in health facilities offering the service in Dakar.Setting The study was conducted in urban slum areas in Dakar.Participants 763 women living in urban slums who had undergone a caesarean section in six health facilities in Dakar between July and December 2022.Outcome measures The proportion of women bypassing the nearest health facility and travel time to health facilities.Results Key findings show that most women in Dakar’s urban slums live within 5 min from a health facility offering caesarean services, with an average travel time of 6.3 min. However, 44.3% bypassed nearby facilities, often travelling outside their district. Medical referral was the primary reason for bypassing (43.2%), followed by the search for higher quality care (13.5%) and reliance on family or social networks (14.9%). Only a small proportion (1.4%) cited more affordable treatment costs as a reason for bypassing.Conclusion Despite the good geographical accessibility of health facilities offering caesarean sections in Dakar, many women bypass nearby facilities due to medical referrals and the search for higher quality care, resulting in increased travel time and costs. Strengthening the quality and capacity of local health centres in urban slums is crucial to minimising unnecessary bypassing and ensuring timely access to essential obstetric services. |
| format | Article |
| id | doaj-art-a95090fabb4f4371a0e979fefee71eef |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a95090fabb4f4371a0e979fefee71eef2025-08-20T03:43:50ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-088606Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slumsWinfred Dotse-Gborgbortsi0Cheikh Faye1Arsene Brunelle Sandie2Fadima Yaya Bocoum3El Hadji Malick Sylla4Ndeye Awa Fall5Barrel Sow Gueye6Diarra Bousso Senghor7Birane Cissé8Ibrahima Ousmane Sy92 School of Geography and Environmental Sciences, University of Southampton, Southampton, UK1 West Africa Regional Office, African Population and Health Research Center (APHRC), Dakar, Senegal1 West Africa Regional Office, African Population and Health Research Center (APHRC), Dakar, Senegal5 Institut de Recherche en Sciences de la Sante, Ouagadougou, Centre, Burkina Faso1 West Africa Regional Office, African Population and Health Research Center (APHRC), Dakar, Senegal1 West Africa Regional Office, African Population and Health Research Center (APHRC), Dakar, Senegal1 West Africa Regional Office, African Population and Health Research Center (APHRC), Dakar, Senegal3 Geography, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal4 Université Cheikh Anta Diop de Dakar, Dakar, Senegal4 Université Cheikh Anta Diop de Dakar, Dakar, SenegalObjective The study examines the geographic accessibility of Comprehensive Emergency Obstetric Care (CEmONC) among women residing in the slums of Dakar.Design The study is a cross-sectional geographic analysis of caesarean care utilisation in health facilities offering the service in Dakar.Setting The study was conducted in urban slum areas in Dakar.Participants 763 women living in urban slums who had undergone a caesarean section in six health facilities in Dakar between July and December 2022.Outcome measures The proportion of women bypassing the nearest health facility and travel time to health facilities.Results Key findings show that most women in Dakar’s urban slums live within 5 min from a health facility offering caesarean services, with an average travel time of 6.3 min. However, 44.3% bypassed nearby facilities, often travelling outside their district. Medical referral was the primary reason for bypassing (43.2%), followed by the search for higher quality care (13.5%) and reliance on family or social networks (14.9%). Only a small proportion (1.4%) cited more affordable treatment costs as a reason for bypassing.Conclusion Despite the good geographical accessibility of health facilities offering caesarean sections in Dakar, many women bypass nearby facilities due to medical referrals and the search for higher quality care, resulting in increased travel time and costs. Strengthening the quality and capacity of local health centres in urban slums is crucial to minimising unnecessary bypassing and ensuring timely access to essential obstetric services.https://bmjopen.bmj.com/content/15/3/e088606.full |
| spellingShingle | Winfred Dotse-Gborgbortsi Cheikh Faye Arsene Brunelle Sandie Fadima Yaya Bocoum El Hadji Malick Sylla Ndeye Awa Fall Barrel Sow Gueye Diarra Bousso Senghor Birane Cissé Ibrahima Ousmane Sy Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums BMJ Open |
| title | Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums |
| title_full | Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums |
| title_fullStr | Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums |
| title_full_unstemmed | Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums |
| title_short | Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar’s slums |
| title_sort | beyond physical accessibility bypassing health facilities offering caesarean section insights from women in dakar s slums |
| url | https://bmjopen.bmj.com/content/15/3/e088606.full |
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