Ameyaw Edward Kwabena, Amoah Roberta Mensima, Njue Carolyne, Tran Nguyen Toan, Dawson Angela
Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, Australia.
Department of Public Health, School of Allied Sciences, University for Development Studies, Tamale, Northern Region, Ghana.
BMC Health Serv Res. 2020 Nov 26;20(1):1088. doi: 10.1186/s12913-020-05937-5.
Access to and delivery of comprehensive emergency obstetric and neonatal care (CEmONC) services are often weak in low and middle-income countries affecting maternal and infant health outcomes. There are no studies on resources for maternal healthcare in the Northern region of Ghana. This knowledge is vital for health service planning and mobilising funding to address identified gaps. We investigated the available resources for managing CEmONC and referral services in the region.
This study involved a cross-sectional survey of maternity facilities in ten hospitals in the Northern region of Ghana, serving a population of 2,479,461, including 582,897 women aged 15-49. Public and faith-based hospitals were included in the study. We used the Service Provision Assessment tool to gather data for this study between October and December 2019. Given the small sample size, we used descriptive statistics to summarise the data using SPSS version 25 and Excel 2016.
A total of 22,271 ANC visits from women to these hospitals occurred in the past 3 months preceding the study; however, 6072 birth events (cases) occurred within the same period. All the hospitals had less than one general medical doctor per 10,000 population (range 0.02-0.30). The number of midwives per 10,000 population ranged from 0.00 (facility H and J) to 1.87 (facility E), and none of the hospitals had a university-trained nurse designated for maternity care. Only one hospital had complete equipment for emergency obstetric and newborn care, while four others had adequate emergency obstetric care equipment. The number of maternity and delivery beds per 10,000 population was low, ranging from 0.40 to 2.13.
The management of emergency obstetric care and referrals are likely to be affected by the limited human resources and equipment in hospitals in Northern Ghana. Financial and non-financial incentives to entice midwives, obstetricians and medical officers to the Northern region should be implemented. Resources should be mobilised to improve the availability of essential equipment such as vacuum extractors and reliable ambulances to enhance referral services. Considerable health system strengthening efforts are required to achieve the required standards.
在低收入和中等收入国家，获得和提供全面的紧急产科和新生儿护理（CEmONC）服务往往较为薄弱，这影响了母婴健康结局。加纳北部地区尚无关于孕产妇保健资源的研究。这些信息对于卫生服务规划和筹集资金以填补已发现的差距至关重要。我们调查了该地区管理CEmONC和转诊服务的可用资源。
本研究对加纳北部地区10家医院的产科设施进行了横断面调查，服务人口为2479461人，其中包括582897名15至49岁的女性。研究纳入了公立医院和教会医院。我们使用服务提供评估工具在2019年10月至12月期间收集本研究的数据。鉴于样本量较小，我们使用描述性统计方法，通过SPSS 25版和Excel 2016对数据进行汇总。
在研究前的过去3个月里，共有22271名妇女到这些医院进行产前检查；然而，同期发生了6072例分娩事件（病例）。所有医院每10000人口中普通医生不到1名（范围为0.02 - 0.30）。每10000人口中助产士的数量从0.00（医院H和J）到1.87（医院E）不等，而且没有一家医院有专门为产科护理指定的大学培训护士。只有一家医院具备完整的紧急产科和新生儿护理设备，另外四家医院有足够的紧急产科护理设备。每10000人口中的产科和分娩床位数量较低，范围为0.40至2.13。
加纳北部医院人力资源和设备有限，可能会影响紧急产科护理和转诊的管理。应实施经济和非经济激励措施，吸引助产士、产科医生和医务人员前往北部地区。应筹集资源，以提高诸如真空吸引器和可靠救护车等基本设备的可用性，以加强转诊服务。需要做出相当大的努力来加强卫生系统，以达到所需标准。
