Browsing by Author "Amoh-Agyei, Grace"

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    Evaluation of comprehensive emergency obstetric care in the Mampong District Hospital
    (2004) Amoh-Agyei, Grace
    The study was undertaken to evaluate comprehensive emergency obstetric care at the Mampong District Hospital in Ashanti Region. It was a descriptive cross-sectional study with a sample size of 200 women who experienced pregnancy related complications. Ten health providers all from the Maternity Wing of the District Hospital were also interviewed. Both closed and open-ended questions were used in designing the questionnaire and interview guide in addition to a checklist for equipment, drugs, supplies and personnel in the facility. The interview guide was pre-tested and used to collect information from respondents using face-to-face interview. The respondents were selected using purposive sampling. The evaluation was made through the measuring of availability, accessibility, adequacy, effectiveness and utilization of CEMOC services. Information collected was analyzed and presented using tables, pie and bar charts. Findings revealed that there were competent and trained personnel even though they were not enough, and there were adequate essential drugs, equipment and supplies to meet the demand from the public. The study also revealed that 83.3% of the respondents were assisted by caesarean section, 14.7% through vacuum extraction and 2% by laparotornies. A large number of women from other districts in the region patronized the facility. From January to September 2003, the facility had supervised 1,271 normal deliveries and managed 791 complicated cases. Most of the women who went for assistance reported with problems ranging between hypertensive disorders, obstructed labour, abortion, retained products, twin deliveries, ectopic pregnancies and bleeding. The finding on accessibility revealed that it was not difficult for clients or patients to get to the facility; 92% of the respondents used public transport, 3.5% used their own cars and 4.5% used hospital ambulance. Again, 74% paid between ¢600,000 and ¢900,000.00 and 26% paid between 01 million and 013 million for cost of services at the facility. 98% of the respondents saw the cost as affordable whilst 2% claimed it was unaffordable. The research also revealed that when women with pregnancy related complications are sent to the facility they are treated and discharged without any being referred. All respondents were able to get their drugs and they were attended to between 5 and 15 minutes after getting to the facility. The case fatality rate at the facility for the period of study was 0.13%. This is an indication of effectiveness. From the above findings, the researcher concluded that CEMOC is highly patronized in the Maternal Wing due to the availability of trained personnel, drugs, equipment and supplies. Cost of services was affordable services provided were adequate and effective. The researcher therefore recommended that policy makers should ensure sufficient budget allocation for sustenance of the programme, and that there should be more trained personnel to reduce the current workload at the facility. An in-service training programme should be intensified for health personnel to enable them remain current. The health insurance scheme should be implemented in the district and clients should be encouraged to settle their debts in good time.
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    Evaluation of strategies for the reduction of maternal mortality in the Sekyere East District: a view through Michael Patton’s focused-utilization model.
    (KNUST, 2017-11) Amoh-Agyei, Grace
    Strategies for preventing maternal deaths have been in existence for more than 20 years in almost all health facilities throughout the world. The study was an evaluation of the existing strategies for the reduction of maternal mortality within the broad framework of the Safe motherhood programme in the Sekyere East District. A focused-case descriptive study in the context of Patton Utilisation-focused evaluation model was employed to evaluate safe motherhood initiatives. This was done using structured questionnaire and observation checklist to observe pregnancy care, labour and delivery processes. The study involved women in reproductive age who developed complications during pregnancy, labour and delivery. In all 412 women who satisfied the inclusion criteria were selected, using simple random sampling while purposive sampling was used to select 22 health staff comprising midwives, orderlies, pharmacist, medical officers and health administrators from Effiduase Hospital. The study results showed that all the essential logistics and supplies needed to save mothers during pregnancy, labour and delivery were available and functioning. There were trained personnel at post. All strategies suggested by the World Health Organization assist mothers during complications in pregnancy were implemented, 76% of the clients attested that there was an enabling environment, 88% said it was not difficult to access the facility, 87% reported that there was service adequacy, while 72% asserted that strategies were acceptable. Strategies appeared effective and resulted in increased utilization which was evident in the low case fatality rate of 0.082%. The study found that the maternal mortality reduction strategies in the district were effectively implemented according to safe motherhood protocols. It is recommended that the necessary resources continue to be provided for the sustenance of the achieved results of the maternal mortality reduction strategies in the district.