The state of surgery, obstetrics, trauma, and anaesthesia care in Ghana: a narrative review.
Ghana
National Surgical Obstetrics and Anaesthesia Plan
global surgery
health system strengthening
policy analysis
Journal
Global health action
ISSN: 1654-9880
Titre abrégé: Glob Health Action
Pays: United States
ID NLM: 101496665
Informations de publication
Date de publication:
31 12 2022
31 12 2022
Historique:
entrez:
12
8
2022
pubmed:
13
8
2022
medline:
17
8
2022
Statut:
ppublish
Résumé
Conditions amenable to surgical, obstetric, trauma, and anaesthesia (SOTA) care are a major contributor to death and disability in Ghana. SOTA care is an essential component of a well-functioning health system, and better understanding of the state of SOTA care in Ghana is necessary to design policies to address gaps in SOTA care delivery. The aim of this study is to assess the current situation of SOTA care in Ghana. A situation analysis was conducted as a narrative review of published scientific literature. Information was extracted from studies according to five health system domains related to SOTA care: service delivery, workforce, infrastructure, finance, and information management. Ghanaians face numerous barriers to accessing quality SOTA care, primarily due to health system inadequacies. Over 77% of surgical operations performed in Ghana are essential procedures, most of which are performed at district-level hospitals that do not have consistent access to imaging and operative room fundamentals. Tertiary facilities have consistent access to these modalities but lack consistent access to oxygen and/or oxygen concentrators on-site as well as surgical supplies and anaesthetic medicines. Ghanaian patients cover up to 91% of direct SOTA costs out-of-pocket, while health insurance only covers up to 14% of the costs. The Ghanaian surgical system also faces severe workforce inadequacies especially in district-level facilities. Most specialty surgeons are concentrated in urban areas. Ghana's health system lacks a solid information management foundation as it does not have centralized SOTA databases, leading to incomplete, poorly coded, and illegible patient information. This review establishes that surgical services provided in Ghana are focused primarily on district-level facilities that lack adequate infrastructure and face workforce shortages, among other challenges. A comprehensive scale-up of Ghana's surgical infrastructure, workforce, national insurance plan, and information systems is warranted to improve Ghana's surgical system.
Sections du résumé
BACKGROUND
Conditions amenable to surgical, obstetric, trauma, and anaesthesia (SOTA) care are a major contributor to death and disability in Ghana. SOTA care is an essential component of a well-functioning health system, and better understanding of the state of SOTA care in Ghana is necessary to design policies to address gaps in SOTA care delivery.
OBJECTIVE
The aim of this study is to assess the current situation of SOTA care in Ghana.
METHODS
A situation analysis was conducted as a narrative review of published scientific literature. Information was extracted from studies according to five health system domains related to SOTA care: service delivery, workforce, infrastructure, finance, and information management.
RESULTS
Ghanaians face numerous barriers to accessing quality SOTA care, primarily due to health system inadequacies. Over 77% of surgical operations performed in Ghana are essential procedures, most of which are performed at district-level hospitals that do not have consistent access to imaging and operative room fundamentals. Tertiary facilities have consistent access to these modalities but lack consistent access to oxygen and/or oxygen concentrators on-site as well as surgical supplies and anaesthetic medicines. Ghanaian patients cover up to 91% of direct SOTA costs out-of-pocket, while health insurance only covers up to 14% of the costs. The Ghanaian surgical system also faces severe workforce inadequacies especially in district-level facilities. Most specialty surgeons are concentrated in urban areas. Ghana's health system lacks a solid information management foundation as it does not have centralized SOTA databases, leading to incomplete, poorly coded, and illegible patient information.
CONCLUSION
This review establishes that surgical services provided in Ghana are focused primarily on district-level facilities that lack adequate infrastructure and face workforce shortages, among other challenges. A comprehensive scale-up of Ghana's surgical infrastructure, workforce, national insurance plan, and information systems is warranted to improve Ghana's surgical system.
Identifiants
pubmed: 35960190
doi: 10.1080/16549716.2022.2104301
pmc: PMC9586599
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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