Perception of Quality of Emergency Obstetric Care in one Municipality in the Northern Region of Ghana

Abstract

Although emergency obstetric care (EmOC) has contributed to significant reductions in maternal mortality rates worldwide, a greater number of women in sub-Saharan Africa continue to die from pregnancy related complications. In this study, attempt was made to identify factors responsible for this trend by exploring the perception of quality of EmOC in selected health facilities in one municipality in Northern Ghana. A qualitative case study approach was employed to draw evidence from observation, focus group discussion and in-depth face-to-face interviews among health care providers, clients and community members. The findings highlight absence of basic facilities and sub-standard care in the only health facility that provided EmOC services in the municipality. Inadequate supply of obstetric drugs and equipment, provider inefficiency and motivation as well as low female autonomy contributed in diverse ways to the outcome of care. Also, stakeholder perception of quality of EmOC unveiled contextual, interpersonal and clinical dimensions. These findings have several implications in the delivery and conceptualisation of quality in the study area. The Ghana Health Service needs to empower basic facilities in the municipality with essential obstetric drugs and equipment required to discharge their core functions. Curriculum adjustment, continuous education and environmental modifications are essential for improving upon provider competencies while cultural reorientation, through targetted health promotion campaigns, has the potential of empowering rural women to take charge of their reproductive health needs.