Quality of emergency obstetric care in Ghana  Seminar

Although women giving birth in health facilities has increased over the years in Ghana, maternal deaths are still unacceptably high. Women dying in health facilities while giving birth brings to question the quality of emergency obstetric care. Are emergency obstetric services available and ready when there is a complication?

Emergency obstetric and newborn care (EmONC) signal functions are the standard indicators for assessing health facility readiness in emergency cases. However, recent literature has proposed a broader range of indicators including routine services and the capacity of health facilities, all of which may affect patient choice of healthcare facility.

In this seminar, we will discuss a recent maternal health service provision assessment (SPA) of 151 health facilities. The SPA was used to develop a quality care index based on a broader set of domains. Two approaches, an index of multiple deprivation and principal component analysis were used to analyse the data. Preliminary visualisations of the origins and destinations of over 40,000 women giving birth in these health facilities will also be discussed.

Initial results show mostly secondary care facilities in higher quality quintiles, where domains measured capacity or physical size of health facilities. However, there is more variation in domains assessing training, water sanitation and hygiene, privacy, and staff motivation. Facility size or tier thus serves as a poor proxy for these aspects of service quality. Going forwards, the study will assess how these quality indicators affect healthcare utilisation through spatial interaction modelling.

Speaker Information

Mr Winfred Dotse-Gborgbortsi - Postgraduate Research Student within Geography and Environmental Science at the University of Southampton.