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Free Content Assessment of capacity for surgery, obstetrics and anaesthesia in 17 Ghanaian hospitals using a WHO assessment tool

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Abstract:

Summary Objectives  To survey infrastructure characteristics, personnel, equipment and procedures of surgical, obstetric and anaesthesia care in 17 hospitals in Ghana. Methods  The assessment was completed by WHO country offices using the World Health Organization Tool for Situational Analysis to Assess Emergency and Essential Surgical Care, which surveyed infrastructure, human resources, types of surgical interventions and equipment in each facility. Results  Overall, hospitals were well equipped with general patient care and surgical supplies. The majority of hospitals had a basic laboratory (100%), running water (94%) and electricity (82%). More than 75% had the basic supplies needed for general patient care and basic intra-operative care, including sterilization. Almost all hospitals were able to perform major surgical procedures such as caesarean sections (88%), herniorrhaphy (100%) and appendectomy (94%), but formal training of providers was limited: a few hospitals had a fully qualified surgeon (29%) or obstetrician (36%) available. Conclusions  The greatest barrier to improving surgical care at district hospitals in Ghana is the shortage of adequately trained medical personnel for emergency and essential surgical procedures. Important future steps include strengthening their number and qualifications.

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Objectifs: 

Surveiller les caractéristiques de l’infrastructure, du personnel, des équipements et procédures pour les soins de chirurgie, d’obstétrique et d’anesthésie dans 17 hôpitaux au Ghana. Méthodes: 

L’évaluation a été réalisée par les bureaux nationaux de l’OMS à l’aide de ‘l’outil d’analyse de situation de l’OMS pour l’évaluation des soins chirurgicaux d’urgence et essentiels’, portant sur l’infrastructure, les ressources humaines, les types d’interventions chirurgicales et l’équipement dans chaque service. Résultats: 

Globalement, les hôpitaux étaient bien équipés avec des fournitures pour les soins généraux aux patients et chirurgicaux. La majorité des hôpitaux avait un laboratoire de base (100%), de l’eau courante (94%) et de l’électricité (82%). Plus de 75% avaient des fournitures de base nécessaires pour les soins généraux aux patients et de base pour des soins intra-opératoires, y compris la stérilisation. Presque tous les hôpitaux étaient en mesure d’effectuer des interventions chirurgicales majeures telles que la césarienne (88%), l’herniorraphie (100%) et l’appendicectomie (94%), mais la formation officielle des prestataires était limitée: peu d’hôpitaux disposaient d’un chirurgien entièrement qualifié (29%) ou un obstétricien (36%). Conclusions: 

Le plus grand obstacle à l’amélioration des soins chirurgicaux dans les hôpitaux de district au Ghana est le manque de formation appropriée du personnel médical d’urgence et pour les interventions chirurgicales essentielles. Les prochaines étapes importantes comprennent le renforcement de leur nombre et leurs qualifications.

Keywords: Africa; Afrique; Ghana; anaesthesia; anestesia; anesthésie; chirurgie; cirugía; obstetricia; obstetrics; obstétrique; surgery; África

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2010.02589.x

Affiliations: 1:  Department of Surgery, Johns Hopkins University, Baltimore MD, USA 2:  Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA 3:  Department of Surgery, Korle Bu Teaching Hospital, Accra, Ghana 4:  Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana 5:  Director-General, Ghana Health Services, Accra, Ghana 6:  World Health Organization Country Office, Accra, Ghana 7:  Department of Medicine, Columbia University Medical Center, New York, NY, USA 8:  Department of Surgery, Columbia University Medical Center, New York, NY, USA 9:  Emergency and Essential Surgical Care Program, Department of Essential Health Technologies, Health Systems and Services, World Health Organization Headquarters, Geneva, Switzerland

Publication date: September 1, 2010

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