Rural healthcare providers coping with clinical care delivery challenges: lessons from three health centres in Ghana
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Family Practice
Abstract
Background: Rural settings in low- and middle-income countries are bedeviled with poverty and high disease
burden, and lack adequate resources to deliver quality healthcare to the population. Drug shortage and inadequate
number and skill-mix of healthcare providers is very common in rural health facilities. Hence, rural healthcare
providers have no choice but to be innovative and introduce some strategies to cope with health delivery
challenges at the health centre levels. This study explored how and why rural healthcare providers cope with
clinical care delivery challenges at the health centre levels in Ghana.
Methods: This study was a multiple case studies involving three districts: Bongo, Kintampo North, and Juaboso
districts. In each case study district, a cross-sectional design was used to explore the research question. Purposive
sampling technique was used to select study sites and the study participants. The authors conducted 11 interviews,
9 focus group discussions (involving 61 participants), and 9-week participant observation (in 3 health centres).
Transcription of the voice-recordings was done verbatim, cleaned and imported into the Nvivo version 11 platform
for analysis. Data was analysed using the inductive content analysis approach. Ethical clearance was granted by the
Ethics Review Committee of the Ghana Health Service.
Results: The study found three main coping strategies (borrowing, knowledge sharing and multi-tasking). First,
borrowing arrangements among primary health care institutions help to address the periodic shortage of medical
supplies at the health centres. Secondly, knowledge sharing among healthcare providers mitigates skills gap during
service delivery; and finally, rural healthcare providers use multi-tasking to avert staff inadequacy challenges during
service delivery at the health centre levels.
Conclusion: Borrowing, knowledge sharing, and multi-tasking are coping strategies that are sustaining and
potentially improving health outcomes at the district levels in Ghana. We recommend that health facilities across all
levels of care in Ghana and other settings with similar challenges could adopt and modify these strategies in order
to ensure quality healthcare delivery amidst delivery challenges
Description
Research Article
Keywords
Rural healthcare providers, Borrowing, Knowledge sharing, Multi-tasking