Mapping essential surgical care in Mongolia: Do natural barriers and seasonality alter access to essential surgical care?

Measures of access to essential surgery in Mongolia have not accounted for natural barriers to movement, seasonality, and the modifiable areal unit problem scale effects. This physical accessibility analysis indicates natural barriers and seasonality threaten access to surgical care, shifting Mongolia from an attaining to a non-attaining country with estimates below the target population goal of 80%. Remote communities are particularly impacted, with access reduced by up to 6.1%. Spatial resolution of the input data influences the results by up to 14.2%. This highlights the importance of including natural barriers and seasonality in healthcare access scenarios using a fine spatial resolution. •Access to essential surgical care in Mongolia does not meet global benchmarks.•Accounting for natural barriers and seasonality reduces physical access estimates.•Remote areas are more likely to experience access reduction than urban areas.•The modifiable areal unit problem impacts estimates in surgical access scenarios.