Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec 12;18(1):959.
doi: 10.1186/s12913-018-3787-1.

Are health facilities well equipped to provide basic quality childbirth services under the free maternal health policy? Findings from rural Northern Ghana

Philip Ayizem Dalinjong  1 , Alex Y Wang  2 , Caroline S E Homer  2
Affiliations

Are health facilities well equipped to provide basic quality childbirth services under the free maternal health policy? Findings from rural Northern Ghana

Philip Ayizem Dalinjong et al. BMC Health Serv Res. .

Abstract

Background: Basic inputs and infrastructure including drugs, supplies, equipment, water and electricity are required for the provision of quality care. In the era of the free maternal health policy in Ghana, it is unclear if such basic inputs are readily accessible in health facilities. The study aimed to assess the availability of basic inputs including drugs, supplies, equipment and emergency transport in health facilities. Women and health providers' views on privacy and satisfaction with quality of care were also assessed.

Methods: The study used a convergent parallel mixed methods in one rural municipality in Ghana, Kassena-Nankana. A survey among facilities (n = 14) was done. Another survey was carried out among women who gave birth in health facilities only (n = 353). A qualitative component involved focus group discussions (FGDs) with women (n = 10) and in-depth interviews (IDIs) with midwives and nurses (n = 25). Data were analysed using descriptive statistics for the quantitative study, while the qualitative data were recorded, transcribed, read and coded using themes.

Results: The survey showed that only two (14%) out of fourteen facilities had clean water, and five (36%) had electricity. Emergency transport for referrals was available in only one (7%) facility. Basic drugs, supplies, equipment and infrastructure especially physical space were inadequate. Rooms used for childbirth in some facilities were small and used for multiple purposes. Eighty-nine percent (n = 314) of women reported lack of privacy during childbirth and this was confirmed in the IDIs. Despite this, 77% of women (n = 272) were very satisfied or satisfied with quality of care for childbirth which was supported in the FGDs. Reasons for women's satisfaction included the availability of midwives to provide childbirth services and to have follow-up homes visits. Some midwives were seen to be patient and empathetic. Providers were not satisfied due to health system challenges.

Conclusion: Government should dedicate more resources to the provision of essential inputs for CHPS compounds providing maternal health services. Health management committees should also endeavour to play an active role in the management of health facilities to ensure efficiency and accountability. These would improve quality service provision and usage, helping to achieve universal health coverage.

Keywords: Availability; Basic inputs; Childbirth; Free maternal health policy; Ghana; Infrastructure; Maternal health services; National Health Insurance; Privacy; Quality care.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The Ethical Review Board of the Navrongo Health Research Centre, Ghana (NHRCIRB217) and the Human Research Ethics Committee of the relevant university (ETH16–0263) approved for the conduct of the study. Written informed consent was obtained from all participants.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Essendi H, Johnson FA, Madise N, Matthews Z, Falkingham J, Bahaj AS, James P, Blunden L. Infrastructural challenges to better health in maternity facilities in rural Kenya: community and healthworker perceptions. Reprod Health. 2015;12:103. - PMC - PubMed
    1. Singh A. Supply-side barriers to maternal health care utilization at health sub-centers in India. PeerJ. 2016;4:e2675. - PMC - PubMed
    1. Adair-Rohani H, Zukor K, Bonjour S, Wilburn S, Kuesel AC, Hebert R, Fletcher ER. Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability. Glob Health Sci Pract. 2013;1(2):249–261. - PMC - PubMed
    1. WHO . Access to modern energy services for health facilities in resource-constrained settings: a review of status, significance, challenges and Measurement. Geneva: World Health Organization; 2015.
    1. WHO . Water, sanitation and hygiene in health care facilities – urgent needs and actions: meeting report. Geneva: World Health Organization (WHO) and United Nations Children’s Fund (UNICEF); 2015.