Quality of care : a review of maternal deaths in a regional hospital in Ghana : original research

The government of Ghana and key stakeholders have put into place several interventions aimed at reducing maternal deaths. At the institutional level, the conduct of maternal deaths audit has been instituted. This also contributes to reducing maternal deaths as shortcomings that may have contributed to such deaths could be identified to inform best practice and forestall such occurrences in the future. The objective of this study was to review the quality of maternal care in a regional hospital. A review of maternal deaths using Quality of Care Evaluation Form adapted from the Komfo Anokye Teaching Hospital (KATH) Maternal Death Audit Evaluation Committee was used. About fifty-five percent, 18 (55%) of cases were deemed to have received adequate documentation, senior clinicians were involved in 26(85%) of cases. Poor documentation, non-involvement of senior clinicians in the management of cases, laboratory related issues particularly in relation to blood and blood products as well as promptness of care and adequacy of intensive care facilities and specialists in the hospital were contributory factors to maternal deaths . These are common themes contributing to maternal deaths in developing countries which need to be urgently tackled. Maternal death review with emphasis on quality of care, coupled with facility gap assessment, is a useful tool to address the adequacy of emergency obstetric care services to prevent further maternal deaths. Le gouvernement du Ghana et les principaux intervenants ont mis en place plusieurs interventions visant areduire la mortalite maternelle. Au niveau institutionnel, l'on a mis en place le processus de verification des deces maternels. Ceci contribue egalement areduire la mortalite maternelle puisque les lacunes qui peuvent avoir contribue aces deces pourraient etre identifiees pour influencer les meilleures pratiques et prevenir de telles occurrences dans l'avenir. L'objectif de cette etude etait d'evaluer la qualite des soins de sante maternelle dans un hopital regional. Un examen des deces maternels a ete effectue al'aide du Formulaire d'Evaluation de la Qualite des Soins adapte du Comite de verification des deces maternels du Centre Hospitalier Universitaire de Komfo Anokye (CHUKA). Il est estime qu'environ cinquante-cinq pour cent, 18 (55%) des cas ont recu une documentation adequate ; des cliniciens chevronnes ont ete impliques dans 26 (85%) des cas. La documentation insuffisante, la non-implication des cliniciens experimentes dans la gestion des cas, les problemes relatifs au laboratoire surtout en ce qui concerne le sang et les produits sanguins ainsi que la rapidite des soins et de l'adequation des services du soin intensif et des specialistes al'hopital, ont ete des facteurs contributifs ala mortalite maternelle. Ce sont des themes communs qui contribuent ala mortalite maternelle dans les pays en developpement qui doivent etre abordes d'urgence. L'examen de deces maternel, tout en mettant l'accent sur la qualite des soins, ajoute al'evaluation de l'ecart de l'installation, est un outil utile pour faire face ala pertinence des services de soins obstetricaux d'urgence pour prevenir d'autres deces maternels.