Timely access to emergency care can substantially reduce mortality. The paper aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child-bearing age. A geocoded inventory of 4908 public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, was assembled using data from various sources. An estimate of 287 282 013 (29·0%) people and 64 495 526 (28·2%) women of child-bearing age were located more than 2-h travel time from the nearest hospital. Only 16 countries reached the international benchmark of more than 80% of their populations living within a 2-h travel time of the nearest hospital and marked differences were observed within and between countries. Physical access to emergency hospital care provided by the public sector in Africa remains poor and varies substantially within and between countries which calls for innovative targeting of emergency care services to reduce these inequities.