Quality of maternity services: a comparative study of two urban health centres in the Kumasi Metropolis
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Date
2000-02-05
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Abstract
The high maternal mortality of 214 per 100,000 live births in Ghana is a source of worry
• to managers of health services, health providers and the whole nation. One way of
• reducing this is through the provision of quality maternity services in the health centres, which form the bulk of the health institutions in Ghana. A study was undertaken between August and November 1999 to assess and compare the care given and the managerial practices being implemented to promote quality maternity care delivery at Manhyia and Suntreso Urban Health Centres in the Kumasi Metropolis. Primary data were collected using structured questionnaires administered to health providers and management and interview guide administered to patients. Secondary data were also collected.
Providers’ understanding of quality maternity care was significantly related to communication of quality standards to them by management and in-service training they had received. Quality maternity standards were communicated to more of the providers at Manhyia Urban Health Centre (MUHC) (7) than SUHC (3). Also, MUHC had more in- service training and better understanding of quality maternity care than providers did at Suntreso Urban Health Centre (SUHC). In-service training was also significantly related to total score obtained by providers in their knowledge in components of maternity care. Ninety-one percent of providers at MUHC had good scores (between 8-13 points out of 15) compared to 75% of providers at SUHC who had similar scores. The majority of providers (MUHC=73%; SUHC=83%) and clients (MUHC=85%; SUHC=95%) perceived the quality of maternity care being provided to be good, very good or excellent. Waiting time, interpersonal relationships and staff punctuality to work were of particular importance to clients at both centres. Waiting time and interpersonal relationships were well perceived by providers at both centres as clients’ expectations. Punctuality to work was however weakly perceived by staff at MUHC while SUHC did not perceive it at all.
Allocation of most of the essential supplies to both health centres was inadequate although the level of adequacy of supplies at SUHC (67%) was relatively higher than
MUHC (59%) for most of the supplies. Frequency of supervision at both health centres was dependent on staff’s competence and experience. The level of supervision was higher, well integrated and involved staff at all levels at MUHC than SUHC. Monitoring at both institutions by management was weak and was not done as a team.
Description
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of Master of Science in Health Services Planning and Management, 2000