Perinatal autopsy in Ghana: Healthcare workers knowledge and attitude
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers in Global Women’s Health
Abstract
Background: Perinatal mortality refers to stillbirths and early neonatal
deaths. Stillbirth, the death of a foetus from 28 weeks or with a birth
weight 1,000 g or above, and early neonatal deaths, the death of a newborn within 24 h of delivery, are among the most distressing global health
problems, with approximately 2 million stillbirths occurring annually.
Although a post-mortem examination of the stillborn baby is essential for
understanding and learning the cause of stillbirth, many couples decline
the procedure. Sub-Saharan Africa has one of the highest stillbirth rates
in the world, yet there is a dearth of studies on post-mortem uptake from
the region.
Aim: To explore healthcare professionals’ views and perceptions of perinatal
autopsy in Ghana.
Methods: Mixed-method approach consisted of semi-structured interviews
and an electronic cross-sectional survey to evaluate the views and
perceptions of healthcare professionals at Korle-Bu Teaching Hospital on
autopsy for stillbirths and early neonatal deaths. Descriptive quantitative
data were summarised in frequencies and percentages, and statistical
results and descriptions were tabulated and coded in terms of types of
barriers. For the qualitative aspect, the audio-taped interviews were
transcribed, themes generated, and direct quotes and descriptions were
coded for all knowledge, beliefs, attitudes and practices concerning the
barriers and facilitators for post-mortem.
Results: Ninety-nine healthcare professionals participated. No participant
had formal training regarding counselling for perinatal autopsy and 40%
had “no idea” who is responsible for counselling and obtaining consent for
a perinatal autopsy. Forty-four percent (44%) of the participants knew of
only the “Conventional/ Full” autopsy and <4% were aware of less invasive
methods of performing an autopsy. Qualitative data showed healthcare
worker influence, religious and financial considerations impede the
implementation of perinatal autopsies. Despite the low uptake of perinatal
autopsies, interviews from healthcare workers suggest acceptance rates
would improve if parents knew about different options, especially less
invasive procedures. Conclusion: At Ghana’s largest referral centre, perinatal autopsy counselling and uptake
are at extremely low levels. Most healthcare professionals have little knowledge, skills, and
capacity to advise parents regarding perinatal autopsies. Training is needed to update the
workforce on recommended perinatal autopsy practices.
Description
Research Article
Keywords
autopsy, consent, post-mortem, stillbirth, mixed method
Citation
Swarray-Deen A, Attah DA, Sefogah PE, Oduro NE, Nuamah HG, Nuamah MA, Adzadi C and Oppong SA (2022) Perinatal autopsy in Ghana: Healthcare workers knowledge and attitude. Front. Glob. Womens Health 3:1021474. doi: 10.3389/fgwh.2022.1021474