Reducing maternal deaths: Greater Accra health workers share best practices
The Greater Accra Regional Health Management Team has held a meeting to discuss efforts underway to reduce maternal deaths in the region.
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For three days, representatives of28 health facilities shared ‘Best practices and innovations for the reduction in maternal and perinatal deaths in the various hospitals and clinics.
Best practices
Dr Mark Aglobitse of the Achimota Hospital said since 2011 there had been no maternal death at the hospital, which sees over 8,000 antenatal clinic registrants a year.
The hospital, he explained, had achieved that through innovations adopted which had greatly reduced risk factors.
He cited, for example, the fact that the hospital had expanded its maternity wing and added a theatre, adding, “This has reduced referrals, as the hospital is able to deal with more cases.”
The expansion had also improved client flow, thereby reducing waiting time, he noted.
Dr Emmanuel K. Srofenyoh of the Ridge Hospital also listed many innovations undertaken by the hospital to reduce maternal deaths.
Among those were the creation and utilisation of a triage area at the Labour Ward for initial assessment of all patients to pick those who needed immediate attention.
The hospital, he said, also used colour-coded wrist bands to help identify high-risk patients and foetal monitoring had also been improved.
Furthermore, convertible labour beds had been procured to allow for more delivery space, he said, adding that that had eliminated the situation of patients lying on the floor.
According to him, the hospital had reduced the rotation of specialised midwives to other areas of the hospital, identified and mentored staff to be ‘trainers’ and ‘champions’ of specialised clinics and also instituted a ‘Best Midwife’ awards scheme.
Dr Ama Tamatey of the La General Hospital said the facility recorded 11 deaths, as against 22 the year before, saying maternal deaths were audited within a week of occurrence.
However, she said, post-mortem examination remained a challenge tothe hospital because it had no facilities to conduct the procedure.
At the Ledzokuku Krowor Municipal (LEKMA) Hospital, pharmacy services have been introduced at the antenatal clinic and medicine fridges have been placed in all the wards to facilitate the timely administration of essential medication.
Daily antenatal clinics are also held and weekly morning clinical seminars for nurses and doctors are also held.
The Princess Marie Louis (PML) Hospital also reported that theatre nurses and critical care nurses worked as general nurses on non-surgical days to augment the staff strength.
In a presentation to open the meeting, Dr Linda A. Vanotoo, the Greater Accra Regional Director of Health Services, said a strong functional health system was required to deliver and maintain quality health care to save the lives of women and deliver healthy babies.
“Pregnancy is a physiological process; the complications are well known and studied, treatments are available for the various complications, trainings have gone on to address ‘perceived gaps’ to improve pregnancy outcome, yet women continue to die through the various stages of pregnancy and childbirth,” she said.
Current situation
Last year, 196 maternal deaths were recorded in the Greater Accra Region. Although this is lower than the 2011 figure of 242, Dr Vanotoo was convinced that a large proportion of the deaths were due to poor professional performance, poor adherence to technical precision and weak monitoring systems.
The health service, she noted, continued to organise training on how to prevent complications, identify risk factors and early warning signs to save mothers’ lives but there was little assessment of how the knowledge acquired was used to effect the needed change at service delivery point.
Dr Vanotoo emphasised that much as pregnancy complications could be picked up based on signs, clients also had explanations for those signs, citing the popular belief that having swollen feet in pregnancy meant the woman was carrying a male child.
There was, therefore, the need for health staff to collaborate with their clients and help them appreciate the complications and their outcomes for a better outcome, she said.
Call to action
Dr Vanotoo appealed to health workers to show dedication to duty at all times and at all levels by adopting the right attitude and technical precision, as patients relied on the credence of the doctors, midwives, nurses, other staff and “we cannot afford to betray this trust”.
She urged them to work with the relevant ministries, departments and agencies (MDAs) to improve support structures such as road, water, food security, education for boys and girls to reduce maternal deaths.
“Many interventions have been introduced in Ghana to save lives. The interventions are simple and well known; it is time to do things differently to achieve different results,” she said.