Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.References
Anderson, F. W., Obed, S. A., Boothman, E. L., & Opare-Ado, H. (2014). The public health impact of training physicians to become OB/GYNs and gynaecologists in Ghana. American Journal of Public Health, 104, S159–S165.
Anderson, F. W. J., & Johnson, T. R. B. (2015). Capacity building in obstetrics and gynaecology through academic partnerships to improve global women’s health beyond 2015. BJOG, 122, 170–173.
Campbell, O. M. R., & Graham, W. J. (2006). Strategies for reducing maternal mortality: Getting on with what works. Lancet, 368, 1284–1299.
D’Ambruoso, L., Abbey, M., & Hussein, J. (2005). Please understand when I cry out in pain: Women’s accounts of maternity services during labour and delivery in Ghana. BMC Public Health, 5, 140.
Der, E. M., Moyer, C., Gyasi, R. K., Akosa, A. B., Tettey, Y., Akakpo, P. K., et al. (2013). Pregnancy related causes of deaths in Ghana: A 5-year retrospective study. Ghana Medical Journal, 47, 158–163.
Fauveau, V., Sherratt, D. R., & De Bernis, L. (2008). Human resources for maternal health: Multi-purpose or specialists? Human Resources for Health, 6, 21.
Ghana Health Service. (2011). National assessment for emergency obstetric and newborn care. Accra: Ministry of Health/Ghana Health Service, Government of Ghana.
Koblinsky, M., Matthews, Z., Hussein, J., Mavalankar, D., Mridha, M. K., Anwar, I., et al. (2006). Going to scale with professional skilled care. Lancet, 368, 1377–1386.
Moyer, C. A., Kolars, C. K., & Busingye, P. (2014). Three years of data on the impact of obstetrician/gynecologist coverage in rural Uganda. International Journal of Gynecology & Obstetrics, 126(3), 284–285.
Nesbitt, R. C., Gabrysch, S., Laub, A., Soremekun, S., Manu, A., Kirkwood, B. R., et al. (2014). Methods to measure potential spatial access to delivery care in low-and middle-income countries: A case study in rural Ghana. International Journal of Health Geographics, 13, 25.
Oiyemhonlan, B., Udofia, E. A., & Punguyire, D. T. (2013). Identifying obstetrical emergencies at Kintampo Municipal Hospital: A perspective from pregnant women and nursing midwives. African Journal of Reproductive Health, 17(2), 133.
Paxton, A., Maine, D., Freedman, L., Fry, D., & Lobis, S. (2005). The evidence for emergency obstetric care. International Journal of Gynecology & Obstetrics, 88(2), 181–193.
Penchansky, R., & Thomas, J. W. (1981). The concept of access: Definition and relationship to consumer satisfaction. Medical Care, 19, 127–140.
The World Health Organization (WHO). (2014). Targets and strategies for ending preventable maternal mortality: Consensus statement. (WHO/RHR/14.21).
World Health Organization. (2009). Report of the WHO/PEPFAR planning meeting on scaling up nursing and medical education. Geneva: WHO. Retrieved Aug 09, 2017 from http://www.who.int/hrh/resources/scaling-up_planning_report.pdf.
Yakong, V. N., Rush, K. L., Bassett-Smith, J., Bottorff, J. L., & Robinson, C. (2010). Women’s experiences of seeking reproductive health care in rural Ghana: Challenges for maternal health service utilization. Journal of Advanced Nursing, 66(11), 2431–2441.
Funding
This study was funded through The William Davidson Institute (WDI) and the University of Michigan Medical School.
Author information
Authors and Affiliations
Contributions
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.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest.
Ethical Approval
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.
Rights and permissions
About this article
Cite this article
Luo, E.M., Opare-Ado, H.S., Adomako, J. et al. Completing the Maternal Care Team: OB/GYN Expertise at Rural District Hospitals in Ghana, a Qualitative Study. Matern Child Health J 22, 1085–1091 (2018). https://doi.org/10.1007/s10995-018-2492-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2492-3