Understanding the gap in emergency obstetric and neonatal care in Ghana through the PREventing Maternal And Neonatal Deaths (PREMAND) study

Objective To explore basic and comprehensive emergency obstetric service provision across four districts in rural northern Ghana, and whether women were more likely to deliver at facilities with more skilled care. Methods Field workers geo‐coded all health facilities in East Mamprusi, Sissala East,...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2019-06, Vol.145 (3), p.343-349
Main Authors: Kaselitz, Elizabeth, James, Katherine H., Aborigo, Raymond A., Agorinya, Isaiah, Moyer, Cheryl A., Williams, John
Format: Article
Language:English
Subjects:
BEMONC
CEMONC
Facility delivery
Geo‐location
Ghana
PREMAND
Skilled providers
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Summary:Objective To explore basic and comprehensive emergency obstetric service provision across four districts in rural northern Ghana, and whether women were more likely to deliver at facilities with more skilled care. Methods Field workers geo‐coded all health facilities in East Mamprusi, Sissala East, Kassena Nankana Municipal, and Kassena Nankana West districts, and administered surveys to assess providers and emergency obstetric care available. Data were also prospectively collected on delivery locations of women and neonates who died, or nearly died (near misses), between September 1, 2015 and April 30, 2017. Results There were 14 physicians for a population of nearly 360 000 women. Six (6%) facilities could provide basic emergency care, and 3 (3%) could provide comprehensive care. Services were distributed unequally, with 6 (67%) of the emergency facilities located in the least populated district. Among the sample of women and neonates who died or nearly died, 175 (39%) delivered at locations unable to provide basic emergency services. Conclusion Access to emergency obstetric and neonatal care was distributed inequitably across these districts, suggesting the need to revisit geographic placement of facilities relative to population. The study also raised the question of how to ensure facilities are equipped to respond to emergencies. Emergency services for mothers and neonates are distributed unequally in the districts studied. Many women are delivering at locations not equipped to respond to emergencies.
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.12803