Completing the Maternal Care Team: OB/GYN Expertise at Rural District Hospitals in Ghana, a Qualitative Study
Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives. Interviews were transcribed verbatim and content analysis was performed to identify common themes. Characteristics quotes were identified to illustrate principal interview themes. Quotes were verified in context by researchers for accuracy. Results Interviews with providers revealed four areas most impacted by an OB/GYN’s leadership and expertise at district hospitals: patient referral patterns, obstetric protocol and training, facility management and organization, and hospital reputation. Discussion OB/GYNs are uniquely positioned to add clinical capacity and care quality to established maternal care teams at district hospitals–empowering district hospitals as reliable care centers throughout rural Ghana for women’s health. Coordinated efforts between government, donors and OBGYN training institutions to provide complete obstetric teams is the next step to achieve the global goal of eliminating preventable maternal mortality by 2030.
KeywordsMaternal mortality Obstetrics Midwives Obstetrics and gynecology Sub-Saharan Africa Ghana Capacity building Sustainable development goals Human resources for health
EL and FA developed the initial research question and protocol structure. HO-A, JA, and KD helped in development of the questionnaire, interview methodology, and site selection in Ghana. EL and TP contributed to the majority of the writing and editing of the manuscript. All authors contributed to the final editing process and identification of research themes and characteristic quotes for inclusion in the manuscript.
This study was funded through The William Davidson Institute (WDI) and the University of Michigan Medical School.
Compliance with Ethical Standards
Conflict of interest
The authors have no conflict of interest.
This IRB was approved through the university of Michigan IRB committee and the Ghana Ethics Review Committee (ERC) in 2009. A notice of study closure/intent to publish was provided to the ERC on 02, July, 2014.
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