Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement

Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi J.; Bookman, Laurel; Owen, Medge D.

doi:10.1016/j.ijgo.2011.08.010

Cited by 47 publications

(38 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation may partly be explained by differences in implementation of national health policies and programs in conjunction with the disparities in additional programs implemented in the regions; examples of such regional differences are the Kybele program in the Greater Accra region (13, 14), kangaroo mother care (55), UNICEF-sponsored ACSD (15) in Northern Ghana, High Impact Rapid Delivery (HIRD) (56), and Project Five Alive (57, 58). The variation may also be driven by differences in baseline rate of neonatal mortality across the regions.…”

Section: Discussionmentioning

confidence: 99%

“…The FANC pursues improvement in maternal and child survival through individualized antenatal care that entails a comprehensive assessment of pregnant women in terms of their socio-cultural beliefs, lifestyle, and medical characteristics to improve early detection and treatment of illness and pregnancy complications. In addition to these national programs and policies, various regions also implemented different intervention programs, for example, the Kybele program in the Greater Accra region (13, 14), Accelerated Child Survival and Development (ACSD) (15) sponsored by United Nation Children and Education Fund (UNICEF) in the Northern, Upper East, and Upper West regions, and Kangaroo Mother Care (KMC) (16) which commenced in six regions in 2007. Although the deadline for the attainment of MDG 4 has elapsed, 99% of childhood mortality still occurs in LMICs (5, 17), with Africa accounting for about 50% (18).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Kayode

Grobbee

Koduah

et al. 2016

Global Health Action

View full text Add to dashboard Cite

BackgroundFollowing the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented.DesignGhana Demographic and Health Survey data (1988–2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges.ResultsSince 1988, the annual average rate of decline in neonatal, infant, and under-five mortality in Ghana was 0.6, 1.0, and 1.2%, respectively. From 1988 to 1989, neonatal, infant, and under-five mortality declined from 48 to 33 per 1,000, 72 to 58 per 1,000, and 108 to 83 per 1,000, respectively, whereas from 1989 to 2008, neonatal mortality increased by 2 per 1,000 while infant and under-five mortality further declined by 6 per 1,000 and 17 per 1,000, respectively. However, the observed declines were not statistically significant except for under-five mortality; thus, the proportion of infant and under-five mortality attributed to neonatal death has increased. Most intervention programs implemented to address childhood mortality seem not to have been implemented comprehensively.ConclusionProgress towards attaining MDG 4 in Ghana was below the targeted rate, particularly for neonatal mortality as most health policies and programs targeted infant and under-five mortality. Implementing neonatal-specific interventions and improving existing programs will be essential to attain SDG 3.2 in Ghana and beyond.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Kayode

Grobbee

Koduah

et al. 2016

Global Health Action

View full text Add to dashboard Cite

show abstract

“…In 2007, Kybele, Inc., a US-based humanitarian organization, began a 5-year partnership with the Ghana Health Service (GHS) to reduce maternal and newborn mortality (13). Ridge Regional Hospital (RRH) in Accra was selected as the primary target facility, because it was the largest GHS hospital in the country.…”

Section: Background and Rationalementioning

confidence: 99%

“…The large hospitals received a high volume of obstetric and surgical cases and were plagued by delay resulting from too many patients and too few resources. This in turn led to high mortality rates (8, 12, 13). …”

Section: Introductionmentioning

confidence: 99%

Where Are They Now? Evolution of a Nurse Anesthesia Training School in Ghana and a Survey of Graduates

Potisek

Hatch

Atito-Narh

et al. 2017

Front. Public Health

View full text Add to dashboard Cite

Ghana, like other countries in sub-Saharan African, has limited access to surgery. One contributing factor is the inadequate number of anesthesia providers. To address this need, Kybele, Inc., a US-based non-governmental organization, partnered with the Ghana Health Service to establish the third nurse anesthesia training school (NATS) in Ghana. The school, based at Ridge Regional Hospital (RRH) in Accra, opened in October 2009. This paper describes the evolution of the training program and presents the curriculum. Second, the results of a voluntary survey conducted among the first four classes of graduates (2011–2014) are presented to determine their perceived strengths and gaps in training and to identify employment locations and equipment availability. Seventy-five of 93 graduates (81%) responded to the survey. The graduates reported working in 39 hospitals across 7 of the 10 regions in Ghana. Six providers (8%) worked alone and 16 (21%) were one of only two providers. Fifty-three providers (71%) had no physician anesthesiologist at their facility. Most providers had access to basic anesthesia equipment; however, there was limited access to emergency airway equipment. While most graduates felt that their training had prepared them for their current positions, 21% reported experiencing a patient death during anesthesia. The NATS at RRH has been sustained and most of the graduates are working in Ghana, filling an important void. Quality improvement and continuing education must be emphasized in an effort to reduce surgical morbidity and mortality in Ghana.

show abstract

“…Best use of resources should probably be guided by the project implementation plans already described by groups such as Kybele and CARE. 6,8,11,12 These projects have shown that the starting point should be assessment and improvement of local infrastructure and resources to acceptable levels, before clinical training and building technical competence are initiated, while looking to establish partnerships with local centers of excellence and training departments. A 2009 editorial highlighted the benefits of the Kybele view that 2 weeks of hands-on training is superior to didactic lectures in obstetric anesthesia.…”

mentioning

confidence: 99%

A Spotlight on Obstetric Anesthesia in the Developing World

Reed

Mumba

Dyer

2015

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement

Abstract: Maternal and newborn mortality were reduced in a low-resource setting when appropriate models for continuous quality improvement were developed and employed.

Cited by 47 publications

References 15 publications

Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Where Are They Now? Evolution of a Nurse Anesthesia Training School in Ghana and a Survey of Graduates

A Spotlight on Obstetric Anesthesia in the Developing World

Contact Info

Product

Resources

About