Introduction
In low- and-middle-income-countries (LMICs) like Ghana, universal access to quality healthcare remains a mirage and this undermines achievement of sustainable development goal (SDG) 3. The
SafeCare
Quality Improvement (QI) programme is an initiative of PharmAccess Foundation, a Netherlands-based non-governmental organisation (NGO). In 2009
SafeCare
QI programme was launched in Ghana to help address gaps in healthcare quality standards, leveraging existing local resources. Over 600 private and public healthcare facilities are currently enrolled in the programme and is being adopted for nation-wide rollout by government of Ghana and implementing partners.
Objective
This paper explored views and experiences of frontline health staff and policy makers on the
SafeCare
quality improvement programme in Ghana and how local resources were leveraged in its implementation.
Methodology
Design/setting: The evaluation was conducted in 53 private and public healthcare facilities from seven administrative regions of Ghana across the coastal, middle, and northern geopolitical belts. The regions are Ashanti (
n
= 12), Bono East (
n
= 8), Bono (
n
= 3), Greater Accra (
n
= 12), Oti (
n
= 4), Savannah (
n
= 8) and Western (
n
= 9).
Sampling: Quota and purposive sampling techniques were used to sample the healthcare facilities in accordance with the study eligibility criteria. Total of 45 focus group discussions (FGDs) and 47 individual in-depth interviews (IDIs) were conducted among frontline staff and policy makers from government and private local partner institutions.
Analysis: Group and individual interviews were audio recorded, transcribed verbatim and thematic content analysis done using
Nvivo
(version 12.0) software.
Findings
Overall, participants perceived the relevance and benefits of the
SafeCare
programme to be "
very satisfactory"
while the programme impact, rollout process and success were perceived to be "
satisfactory"
. Quality healthcare standards were perceived to have improved in beneficiary health facilities due to participation in the
SafeCare
programme. Patient satisfaction, service utilisation and revenue generation in healthcare facilities were also attributed to the
SafeCare
programme. Proposals were made for harmonisation of existing QI assessment tools to mitigate duplications. Agreed data sharing protocols and interoperability with existing national database were also recommended to promote sustainability. Finally, low staff motivation, hig...
