Policies for Improving Access to and Quality of Basic and Essential Surgical Care at District Hospitals in Ghana

Abstract

Background: Ghana Health Service has, as one of its major functions, the provision of accessible healthcare to the rural population with regards to surgical and other medical problems requiring hospital care.

Methods: Data was obtained from ten district hospitals through interviews with health personnel, from theatre records and by the completion of a questionnaire before the visit of research team members, who then interviewed the person who completed the questionnaire.

Results: None of the physicians working in these facilities had any formal surgical training beyond that obtained in medical school and during a six-month rotation each in surgery and obstetrics and gynaecology. They performed various emergency and elective surgical procedures such as caesarean sections, laparotomies for typhoid ileal perforation, herniorrhaphies, excision of lumps, among others.

Outcome measures: Interim measures to expand the quantity and quality of emergency and ssential surgical care at district hospitals include compulsory short-term surgical training for medical officers prior to assuming their responsibilities, making available opportunities for continuing short-term surgical education and additional surgical training for medical officers currently working in district hospitals, provision of financial and nonfinancial incentives to physicians with surgical training or surgical experience to entice them to occupy positions in such facilities and training of diplomates and non-physician clinicians to perform the most common emergency and essential surgical  procedures.

Conclusion: In the absence of surgical specialists in the District Hospitals, measures are needed to expand access to proper emergency and essential surgical service for the over 60% of the rural population.