Inequities in geographic access to emergency obstetric and newborn care in Greater Accra

Abstract This study assessed the levels and inequities of geographic accessibility to comprehensive emergency obstetric and newborn care (EmONC) facilities across all 29 districts of Greater Accra Region using peak and non-peak travel time estimates derived from the Google Maps Directions Application Programming Interface. We calculated median travel times (MTT), the proportion of women aged 15–49 years and reachable facilities within 15-, 30- and 60-min thresholds, stratified by wealth. MTT to the nearest public comprehensive EmONC facility was 29.7 min during peak traffic. Nearly 90% of women were within 30 min of public comprehensive EmONC, and 93% were within 30 min of public or private care. In peri-urban areas, public facilities reachable within 30 min dropped from at least one during non-peak to none during peak traffic. Geographic accessibility was notably better among the wealthiest 40%. Our findings highlight geographic and socioeconomic inequities, calling for targeted investments especially in peri-urban areas.