Bigool Mark, Osei Owusu Nicodemus, Frimpong Angela Anastasia
Department of Management, School of Business, University of Cape Coast, Ghana.
J Public Health Afr. 2022 Oct 20;13(3):2183. doi: 10.4081/jphia.2022.2183. eCollection 2022 Sep 7.
Between 2014 and 2017, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), Ghana implemented a nutrition project in two regions of the country using a quality improvement approach. The quality improvement approach focused on improving antenatal care attendance and institutional births.
This study examines the effect of the quality improvement initiative on maternal healthcare service utilization in Ghana and whether the services provided were of quality.
We use the 2014 and the 2008 Ghana Demographic and Health Survey dataset, which is a cross sectional survey and the difference-in-difference approach.
We find strong positive association of the project impact on the probability of antenatal care attendance during the first trimester by 12% points while institutional births were seen to be 8% points. We also find a statistically significant impact of the care rendered by the nurse/midwife to be 13% points and the community health officer/nurse by 4.5% points.
The findings indicate that pregnant women in the intervention regions were more likely to deliver at the health facilities than in the non-intervention regions. It is therefore recommended that Ghana and other low resource countries can better improve maternal health care service uptake with the incorporation of quality improvement tools in maternal health care policy designs.
2014年至2017年期间，全球营养领域加强伙伴关系、成果与创新项目（SPRING）在加纳的两个地区采用质量改进方法实施了一个营养项目。该质量改进方法侧重于提高产前检查出勤率和机构分娩率。
本研究考察了质量改进举措对加纳孕产妇医疗服务利用情况的影响，以及所提供的服务是否具有质量。
我们使用了2014年和2008年加纳人口与健康调查数据集，这是一项横断面调查，并采用了差分法。
我们发现该项目对孕早期产前检查出勤率的概率有强烈的正向关联，提高了12个百分点，而机构分娩率提高了8个百分点。我们还发现，护士/助产士提供的护理影响在统计学上显著，提高了13个百分点，社区卫生官员/护士提供的护理影响提高了4.5个百分点。
研究结果表明，干预地区的孕妇在医疗机构分娩的可能性高于非干预地区。因此，建议加纳和其他资源匮乏的国家在孕产妇保健政策设计中纳入质量改进工具，以更好地提高孕产妇保健服务的利用率。
