Preparedness of health facilities and their midwives for  emergency obstetric and neonatal care services in Accra,  Ghana: A multicenter cross-sectional study:

Michael Yaw Amoh; Ernest Tei Maya; Stephen Tetteh Engmann; Donne Kofi Ameme; Kareem Mumuni; Kwaku Asah-Opoku

Michael Yaw Amoh Reproductive Health and Family Planning Unit, Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
Ernest Tei Maya Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
Stephen Tetteh Engmann Department of Family Medicine, Manna Mission Hospital, Accra, Ghana
Donne Kofi Ameme Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Legon, Accra, Ghana
Kareem Mumuni Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
Kwaku Asah-Opoku Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana

Keywords: Preparedness, health facilities, midwives, emergency, obstetric, neonatal care

Abstract

Background: Emergency Obstetric and Neonatal Care (EmONC) provides comprehensive medical care to women and their newborns during pregnancy, childbirth, and the immediate postnatal period. The timely provision of EmONC can prevent most maternal and early neonatal deaths. In sub-Saharan Africa, including Ghana, maternal and neonatal mortality rates remain unacceptably high, largely because of a lack of access to quality healthcare and poorly prepared health systems. A recent EmONC assessment of public and private health facilities in Ghana revealed capacity gaps in basic pre-referral procedures at the referring health facilities, resulting in maternal deaths.
Objective: The study sought to determine the preparedness of health facilities and their midwives for EmONC services in Accra, Ghana.
Methods: A multicenter analytic cross-sectional study was conducted in Accra, Ghana, from 1st June to 31st July 2020. A total of 194 randomly selected midwives answered a self-administered questionnaire to assess their knowledge and preparedness for EmONC. The factors associated with the preparedness of the midwives for EmONC procedures were determined using chi-square analysis and logistic regression. P-value of <0.05 at 95% confidence interval was considered statistically significant. Availability of EmONC signal functions in health facilities was scored.
Results: Eighty-seven (45%) of midwives had adequate knowledge of EmONC, while only 19% (n = 36) were adequately prepared for EmONC. The factors associated with being prepared for EmONC services were currently working at the labour ward (aOR, 3.43; 95% CI, 1.49 – 7.91) and being a senior midwifery officer or higher (aOR, 6.00; 95% CI, 1.01 – 35.75). Both facilities A and B had a high availability of essential medicines, protocols, and equipment of 90.7%, while facility C had a significantly lower availability of 69.8%.
Conclusion: Despite well-equipped facilities for EmONC, midwives' limited knowledge and preparedness for EmONC can compromise maternal and neonatal outcomes. A thorough review of the midwifery curriculum, clinical training, and the implementation of regular, mandatory training are crucial to ensure their skills align with best practices.

Preparedness of health facilities and their midwives for emergency obstetric and neonatal care services in Accra, Ghana: A multicenter cross-sectional study

Emergency obstetric and neonatal care readiness in Accra

Abstract