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Conducting an audit to improve the facilitation of emergency maternal and newborn referral in northern Ghana

Awoonor-Williams, John Koku and Bailey, Patricia E. and Yeji, Francis and Adongo, Ayire Emmanuel and Baffoe, Peter and Williams, Afua and Mercer, Sarah. (2015) Conducting an audit to improve the facilitation of emergency maternal and newborn referral in northern Ghana. Global public health, Vol. 10, H. 9. S. 1118-1133.

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Official URL: http://edoc.unibas.ch/dok/A6438838

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Abstract

Ghana Health Service conducted an audit to strengthen the referral system for pregnant or recently pregnant women and newborns in northern Ghana. The audit took place in 16 facilities with two 3-month cycles of data collection in 2011. Midwife-led teams tracked 446 referred women until they received definitive treatment. Between the two audit cycles, teams identified and implemented interventions to address gaps in referral services. During this time period, we observed important increases in facilitating referral mechanisms, including a decrease in the dependence on taxis in favour of national or facility ambulances/vehicles; an increase in health workers escorting referrals to the appropriate receiving facility; greater use of referral slips and calling ahead to alert receiving facilities and higher feedback rates. As referral systems require attention from multiple levels of engagement, on the provider end we found that regional managers increasingly resolved staffing shortages; district management addressed the costliness and lack of transport and increased midwives' ability to communicate with pregnant women and drivers; and that facility staff increasingly adhered to guidelines and facilitating mechanisms. By conducting an audit of maternal and newborn referrals, the Ghana Health Service identified areas for improvement that service providers and management at multiple levels addressed, demonstrating a platform for problem solving that could be a model elsewhere.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Systems Research and Dynamic Modelling > Health Systems and Policies (de Savigny)
UniBasel Contributors:Awoonor-Williams, John Koku
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Routledge
ISSN:1744-1692
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Nov 2015 10:21
Deposited On:06 Nov 2015 10:21

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