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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Care Decision Making of Frontline Providers of Maternal and Newborn Health Services in the Greater Accra Region of Ghana
PLoS ONE, Volume 8, No. 2, Article e55610, Year 2013
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Description
Objectives: To explore the "how" and "why" of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes. Methods: A cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnaire and observational checklist to frontline providers of maternal and newborn care. Results: Tacit knowledge or 'mind lines' was an important primary approach to care decision making. When available, protocols and guidelines were used as decision making aids, especially when they were simple handy tools and in situations where providers were not sure what their next step in management had to be. Expert opinion and peer consultation were also used through face to face discussions, phone calls, text messages, and occasional emails depending on the urgency and communication medium access. Health system constraints such as availability of staff, essential medicines, supplies and equipment; management issues (including leadership and interpersonal relations among staff), and barriers to referral were important influences in decision making. Frontline health providers welcomed the idea of interventions to support clinical decision making and made several proposals towards the development of such an intervention. They felt such an intervention ought to be multi-faceted to impact the multiple influences simultaneously. Effective interventions would also need to address immediate challenges as well as more long-term challenges influencing decision-making. Conclusion: Supporting frontline worker clinical decision making for maternal and newborn services is an important but neglected aspect of improved quality of care towards attainment of MDG 4 & 5. A multi-faceted intervention is probably the best way to make a difference given the multiple inter-related issues. © 2013 Oduro-Mensah et al.
Authors & Co-Authors
Oduro-Mensah, Ebenezer
Ghana, Accra
Ridge Regional Hospital Opd
Kwamie, Aku
Ghana, Accra
Accra Ghana/wagningen University
Antwi, Edward
Ghana, Accra
Public Health Specialist
Amissah Bamfo, Sarah
Ghana, Accra
Clinical Care Division
Bainson, Helen Mary
Ghana, Accra
Public Health Specialist
Marfo, Benjamin Aboagye
Ghana, Accra
Ghana Health Service
Coleman, Mary Amoakoh
Ghana, Accra
University of Ghana
Grobbee, Diederick E Egbertus
Netherlands, Utrecht
University Medical Center Utrecht
Agyepong, Irène Akua
Ghana, Accra
University of Ghana
Statistics
Citations: 52
Authors: 9
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0055610
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Qualitative
Study Locations
Ghana