The state of surgery, obstetrics, trauma, and anaesthesia care in Ghana: a narrative review

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The state of surgery, obstetrics, trauma, and anaesthesia care in Ghana: a narrative review


JournalGlobal Health Action
Article typeJournal research article – Literature review
Publication date – Aug – 2022
Authors – Desmond T. Jumbam, Emmanuella Amoako, Paa-Kwesi Blankson, Meredith Xepoleas, Shady Said, Elikem Nyavor, Adam Gyedu, Opoku W. Ampomah, Ulrick Sidney Kanmounye
KeywordsGhana, global surgery, Health system strengthening, National Surgical Obstetrics and Anaesthesia Planpolicy analysis
Open access – Yes
SpecialityAnaesthesia, Obstetrics and Gynaecology, Trauma surgery
World region Western Africa
Country: Ghana
Language – English
Submitted to the One Surgery Index on August 25, 2022 at 9:11 pm
Abstract:

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.

OSI Number – 21739

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