Perspectives of healthcare workers on the challenges with obstetric referrals in rural communities in Ghana : a descriptive phenomenology study

Veronica Millicent DZOMEKU*, Adwoa Bemah Boamah MENSAH, Emmanuel Kweku NAKUA, Pascal AGBADI, Joshua OKYERE, Alex KUMAH, Jacob MUNUKPA, Anthony Adofo OFOSU, Nancy LOCKHART, Jody R. LORI

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

Abstract

OBJECTIVE: We explored and document healthcare workers' (HCWs') perspectives on the challenges encountered during obstetric referrals. 

DESIGN: The study adopted a qualitative research approach and a descriptive phenomenology design. HCWs permanently working in 16 rural healthcare facilities in the Sene East and West Districts composed of the target population for this study. Using a purposive sampling technique, participants were recruited and enrolled in in-depth individual interviews (n=25) and focused group discussions (n=12). Data were analysed thematically using QSR NVivo V.12. 

SETTING: Sixteen rural healthcare facilities in the Sene East and West Districts, Ghana. 

PARTICIPANTS: Healthcare workers. 

RESULTS: Areas related to patient as well as institutional level issues challenged the referral processes. At the patients' level, financial constraints, fears associated with referral and patients' non-compliance with referrals were identified as challenges that delayed the referral process. With regard to institutional challenges, the following emerged: referral transportation challenges, poor attitudes of service providers, low staff strength and healthcare bureaucracies. 

CONCLUSION: We conclude that in order for obstetric referrals in rural Ghana to be effective and timely, there is the need to raise more awareness about the need for patients to comply with referral directives, through health education messages and campaigns. Given our findings on the delays associated with long deliberations, the study recommends the training of more cadre of healthcare providers to facilitate obstetric referral processes. Such an intervention would help to improve the current low staff strength. Also, there is a need to improve ambulatory services in rural communities to counteract the challenges that poor transportation system poses on obstetric referrals.

Original languageEnglish
Article numbere066910
JournalBMJ Open
Volume13
Issue number4
DOIs
Publication statusPublished - 13 Apr 2023

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • Health policy
  • OBSTETRICS
  • PUBLIC HEALTH

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