Department of Public Administration and Health Service Management
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Item Number of students in clinical placement and the quality of the clinical learning environment: A cross-sectional study of nursing and midwifery students(Nurse Education Today, 2021) Abuosi, A.A.; Anaba, E.A.; Kwadan, A.N.; et al.Background: Clinical placement is an important component of nursing and midwifery education. It exposes students to the real-world healthcare environment, where theoretical knowledge is put into practice. However, the quality of the clinical learning environment in sub-Sahara Africa has not been well explored. Objective: The objectives of this study were to assess trainees' perceptions of the number of students on the ward or clinical unit, and the quality of the clinical learning environment. Design: Cross-sectional survey. Setting: Nursing and midwifery students were recruited from three public hospitals in the Upper East Region. Ghana, between July and August 2019. Participants: 254 nursing and midwifery students were recruited using the convenience sampling technique. Methods: Data were collected with the Clinical Learning Environment and Supervision + Nurse Teacher Questionnaire. Data were analysed using univariate, bivariate and multivariable analyses. Results: It was found that the participants rated supervisory relationship; pedagogical atmosphere; role of nurse teacher; leadership style of ward managers; and premises of care on the ward as average. Students' perceptions of the quality of the clinical learning environment were predicted by the supervisory relationship (β = 0.219, 95% CI: 0.016-0.070), leadership style (β = 0.199, 95% CI: 0.011-0.133) and perception of number of students in clinical placement (β = 0.224, 95%CI: 0.022-0.093). The trainees indicated that the number of students on the ward did not correspond with the amount of medical equipment and supervisors. Conclusion: The quality of the clinical learning environment was perceived to be suboptimal. Leadership style, supervisory relationship and perceptions of the number of students on the ward were the salient factors that influenced students' perceptions of the quality of the clinical learning environment. Leaders of nursing and midwifery training institutions must liaise with stakeholders to enhance the quality of clinical learning environment.Item Patient satisfaction with perioperative nursing care in a tertiary hospital in Ghana(International Journal of Health Care Quality Assurance, 2020) Anaba, P.; Anaba, E.A.; Abuosi, A.A.Purpose – Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana. Design/methodology/approach – The study was a cross-sectional study. A sample of one hundred (n 5 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses. Findings – It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision (p< 0.001), nurse–patient relationship (p< 0.001), fear and concern (p< 0.05) and discomfort and need (p < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse–patient relationship (β 5 0.430, p 5 0.002). Originality/value – There is limited literature on nursing care in surgical departments and rarely are patients’ views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.Item Adjustments in purchasing arrangements to support the COVID-19 health sector response: evidence from eight middle-income countries(Health Policy and Planning, 2024) Parmar, D.; Mathauer, I.; Abuosi, A.A.; et al.The COVID-19 pandemic has triggered several changes in countries’ health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run.Item Assessing the efficiency of regional hospitals in Ghana: Implications for optimal resource allocation for referral hospitals(Scientific African, 2023) Vukey, E.Y.; Ntow-Kummi, G.; Abuosi, A.A.Scarcity of resources, high expenditure, and ineffective resource use characterise healthcare in Ghana. The symptom of inadequate hospital resource utilisation gave rise to the popular term ’no bed syndrome’ in some Ghanaian regional hospitals. Under these circumstances, patients are continually turned away from receiving treatment because of inadequate beds especially in the emergency and surgical units. Therefore, this study assesses the efficiency of four (4) regional hospitals in Ghana in 2020. Secondary data on bed occupancy rates, average length of stay and bed turnover rates, among others, were collected from District Health Information Management System (DHIMS) for further analysis. Pabon ´ Lasso charts were drawn using Microsoft Excel 2019 to evaluate the efficiency level of hospitals and wards. The results show that the Greater Accra and Brong Ahafo Regional Hospitals were inefficient, the Upper East Regional Hospital was less efficient and the Eastern Regional Hospital was efficient. Findings also indicate that the medical, maternity and surgical wards of the Brong Ahafo Regional Hospital were inefficient. However, the emergency ward was the most efficient in the Eastern Regional Hospital but that of the Upper East Regional Hospital was inefficient. The medical and surgical wards of the Greater Accra Regional Hospital were less efficient. These findings have practical implications for designing policy in struments to promote healthcare delivery in Ghana.Item Comparing patient safety culture in primary, secondary and tertiary hospitals in Ghana(Ghana Medical Journal, 2023) Abuosi, A.A.; Anaba, E.A.; Attafuah, P.Y.A.; Tenza, I.S.; Abor, P.A.; Setordji, A.; Nketiah-Amponsah, E.Objective: This study compared patient safety culture among health professionals in tertiary, secondary and primary hospitals. Design: We conducted a cross-sectional survey among thirteen primary, secondary and tertiary hospitals in Ghana. A structured questionnaire was administered to 1,656 health professionals. Data were analysed using descriptive statis tics and One-Way Analysis of Variance (ANOVA). Setting: This study was conducted in the Greater Accra, Bono and Upper East regions, representing the southern, middle and northern ecological zones, respectively. Participants: Health professionals Main outcome measures: The primary outcome was patient safety culture. Results: Five patient safety culture dimensions were rated moderate positive response, while five were rated high positive response. We found a statistically significant difference in patient safety culture across primary, secondary and tertiary hospitals (p < 0.05). For instance, the mean difference between tertiary and secondary hospitals was sta tistically significant (p < 0.05). Additionally, the mean difference between tertiary and primary hospitals was statisti cally significant (p < 0.05). There was also a significant difference in the means between secondary and primary hospitals (p < 0.05). Conclusion: This study has demonstrated a variation in patient safety culture across Ghana’s tertiary, secondary and primary hospitals. Therefore, healthcare managers and professionals should prioritise patient safety.Item Towards a comprehensive breastfeedingfriendly workplace environment: insight from selected healthcare facilities in the central region of Ghana(BMC, 2021) Nkrumah, J.; Abuosi, A.A.; Nkrumah, R.B.Background: In the last three decades, Ghana has championed the objectives of Baby-Friendly Hospital Initiatives to provide pregnant women and nursing mothers with the skills and support systems necessary for attaining optimal breastfeeding. Yet, little is known in literature on how these intervention regimes practically promote breastfeeding-friendly work environment in healthcare facilities and their level of effectiveness. This study explores the extent to which healthcare facilities in Ghana’s Effutu Municipality provide breastfeeding-friendly workplace environment to breastfeeding frontline health workers. Methods: A descriptive mixed-method approach was employed to collect data from fifty-four participants, comprising healthcare facility representatives and breastfeeding frontline health workers. A self-administered questionnaire with structured responses was administered to frontline health workers, followed by interview guides for representatives of hospital management. Thematic analysis was used to analyze interview responses. Responses to questionnaires were processed with SPSS version 23.0 and presented using frequencies and percentages. Results: Three main themes emerged, namely, Standpoints on workplace breastfeeding support; Breastfeeding support, and Suggested future directions. Beyond this, six sub-themes emerged, including backings for workplace breastfeeding support; perceived benefits of breastfeeding support; factors of poor breastfeeding workplace support; maternity protection benefits; workplace support gaps, and awareness creation on benefits. Breastfeeding frontline health workers held that their hospitals have no breastfeeding policy (96%), no breastfeeding facility (96%), they do not go to work with baby (96%), but had 12 weeks maternity leave (96%) and worked half-day upon return to work (70%). Conclusion: Health facilities in the study do not provide a breastfeeding-friendly work environment except for the privileges provided by the Labor Act and conditions of service. Continuous advocacy on breastfeeding workplace support and stakeholder engagement to build consensus on the mix of strategies suitable to cushion breastfeeding frontline health workers is recommended for optimal breastfeeding and improved productivity.Item Relationship between clinical governance and hospital performance: a cross-sectional study of psychiatric hospitals in Ghana(International Journal of Health Governance, 2021) Abor, P.A.; Abuosi, A.A.; Azilaku, J.C.; Anaba, E.A.; Titiati, A.Purpose – Clinical governance (CG) is crucial for healthcare quality of care improvement and safeguarding high standards of care. Little is known about CG in sub-Saharan Africa. The authors assessed health workers’ perceptions of CG and hospital performance in Ghana’s psychiatric hospitals. Design/methodology/approach – A cross-sectional survey was conducted among 230 health workers across two psychiatric hospitals in Ghana. Data were collected with a structured questionnaire and analyzed with Statistical Package for Social Sciences (SPSS), version 23.0. Findings – The majority (59.5%) of the respondents were females. The authors found that less than five in ten respondents felt that the hospitals have adopted measures to promote quality assurance (43.2%) and research and development (43.7%). However, a little above half of the respondents felt that the hospitals have adopted measures to promote education and training (57.7%); clinical audit (52.7%); risk management (50.7%) and clinical effectiveness (68.6%). The authors also found a statistically significant association between CG and hospital performance (p < 0.05). Research limitations/implications – There was a positive relationship between CG and hospital performance. Therefore, investing in CG may help to increase hospital performance. Originality/value – This is the maiden study to investigate CG and hospital performance in Ghana’s psychiatric hospitals and one of the few studies in Africa. This study makes a modest contribution to the global discourse on the subject matterItem Prostate cancer awareness and attitude toward early detection among male soldiers in Ghana: a cross‑sectional study(African Journal of Urology, 2019-12-10) Anaba, E.A.; Necku, J.G.; Abuosi, A.A.Background: Prostate cancer (PC) is the leading cause of cancer deaths among men in Ghana. This poses a public health threat, especially among the Ghana Armed Force (GAF) where the majority are males. This study aimed to assess male soldiers’ awareness, knowledge and attitudes toward early detection of prostate cancer. Results: It was found that 58.3% of the soldiers were less aware of PC and 76.0% had low or neutral knowledge regarding risk factors and symptoms of PC. The soldiers had positive attitudes toward early detection but had low intentions of getting tested. Awareness was significantly associated with education, rank, haven received PC information from a health worker and being knowledgeable of signs of PC. Conclusion: We recommend that management of the GAF should liaise with the Ministry of Health to sensitize and educate soldiers on prostate cancer, and if possible, organize periodic screening activities for the soldiers to aid in early detection and effective management of the disease. The findings of this study provide valuable information for health interventions in Ghana.Item A cross-sectional survey on patient safety culture among healthcare providers in the Upper East region of Ghana(Plos One, 2019-08-20) Akologo, A.; Abuosi, A.A.; Anaba, E.A.Introduction Adverse events pose a serious threat to quality patient care. Promoting a culture of safety is essential for reducing adverse events. This study aims to assess healthcare providers’ perceptions of patient safety culture in three selected hospitals in the Upper East region of Ghana. Methods The English version of the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was administered to 406 clinical staff. Statistical Package for Social Science (SPSS) software, version 23, was used to analyze the data. The results were presented using descriptive statistics, Pearson Correlation Analysis and One-way Analysis of Variance (ANOVA). Results It was found that two out of twelve patient safety culture dimensions recorded high positive response rates (� 70%). These include teamwork within units (81.5%) and organizational learning (73.1%). Three patient safety culture dimensions (i.e. staffing, non-punitive response to error and frequency of events reported) recorded low positive response rates (� 50%). The overall perception of patient safety correlated significantly with all patient safety culture dimensions, except staffing. There was no statistically significant difference in the overall perception of patient safety among the three hospitals. Conclusion Generally, healthcare providers in this study perceived patient safety culture in their units as quite good. Some of the respondents perceived punitive response to errors. Going forward, healthcare policy-makers and managers should make patient safety culture a top priority. The managers should consider creating a ‘blame-free’ environment to promote adverse event reporting in the hospitalsItem Patient satisfaction with the quality of care in Ghana’s health-care institutions A disaggregated approach(International Journal of Pharmaceutical and Healthcare Marketing, 2019-04-16) Abuosi, A.A.; Braimah, M.Purpose – The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach – The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings – About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients weremore likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications – Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications – The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value – There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.
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