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Care-seeking factors include delays arising from ignorance, cost of care and lack of adequate means of transportation. Also, health seeking behaviours influence the accessibility and affordability to emergency care. Other factors affecting choice of a service range from home initiated interventions to patronage of drug shops for convenience, knowledge and perceived severity of the ailment, cleanliness and structure (aesthetics) of hospitals and availability of specialists or proficient staff.
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Delays in care are related to financial costs, that is usually borne out of lack of preparedness.
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Ability of households to afford the cost of health care is important because affordability issues can totally truncate access and depends primarily on household income. The readiness and ability to afford care for sudden health challenges have been variably evaluated across many populations. Despite evidence of the cost-effectiveness of surgery, many LMIC households are still unable to afford it. The high burden of emergency care in low- and middle income countries (LMIC) has been attributed to factors such as lack of adequate health care resources, unorganized systems, that are complicated by the migration of health care professionals and cost factors. Sub-Saharan Africa has the highest proportion of disability-adjusted life years (DALYs) due to surgical conditions estimated at 38 DALYs per 1,000 population. Globally, emergency surgical procedures totaled over 230 million cases about a decade ago and emergency cesarean section (CS), comprises a significant proportion of the 18.5 million CS cases worldwide. Emergency surgery is defined as ‘ surgical procedures that cannot be delayed, for which there is no alternative therapy, and for which a delay could result in death or permanent impairment of health’. Needed sudden care may be medical or surgical and is often critically urgent to avoid aggravated morbidity or mortality.
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Sixteenth participant Male, Slum dweller, 27years and sought care in a public secondary facilityĮmergency care is an essential component of health systems. Twenty-fourth participant Female, Slum dweller, 37years and sought care in a private secondary facility. The funders had no role in the study design, data collection and analysis, decision to publish or manuscript preparation.Ĭompeting interests: The authors have declared that no competing interests exist.įifteenth participant Female, Non-Slum dweller, 32years and sought care in a public secondary facility R24_F_SD_37years_private, At the time of writing, S.F was supported by a Fulbright Senior Fellow Award at the University of Southern California, an award from the Oppenheimer Memorial Trust, and an Anderson Capelli fellowship. The research was also partly funded by Premier Medicaid International HMO. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No-B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files can be found in figshare doi: 10.6084/m9.figshare.11417994.įunding: T.O is a fellow of the Consortium for Advanced Research Training in Africa (CARTA) and this research is supported by CARTA. Received: AugAccepted: ApPublished: May 20, 2020Ĭopyright: © 2020 Obembe, Fonn. PLoS ONE 15(5):Įditor: Rosa Maria Urbanos Garrido, University Complutense of Madrid, SPAIN Citation: Obembe T, Fonn S (2020) Affording unavoidable emergency surgical care – The lived experiences and payment coping strategies of households in Ibadan metropolis, Southwestern Nigeria.