PMID- 30874303
OWN - NLM
STAT- Publisher
LR  - 20190403
IS  - 1879-3479 (Electronic)
IS  - 0020-7292 (Linking)
DP  - 2019 Mar 15
TI  - Understanding the gap in emergency obstetric and neonatal care in Ghana through
      the PREventing Maternal And Neonatal Deaths (PREMAND) study.
LID - 10.1002/ijgo.12803 [doi]
AB  - OBJECTIVE: To explore basic and comprehensive emergency obstetric service
      provision across four districts in rural northern Ghana, and whether women were
      more likely to deliver at facilities with more skilled care. METHODS: Field
      workers geo-coded all health facilities in East Mamprusi, Sissala East, Kassena
      Nankana Municipal, and Kassena Nankana West districts, and administered surveys
      to assess providers and emergency obstetric care available. Data were also
      prospectively collected on delivery locations of women and neonates who died, or 
      nearly died (near misses), between September 1, 2015 and April 30, 2017. RESULTS:
      There were 14 physicians for a population of nearly 360 000 women. Six (6%)
      facilities could provide basic emergency care, and 3 (3%) could provide
      comprehensive care. Services were distributed unequally, with 6 (67%) of the
      emergency facilities located in the least populated district. Among the sample of
      women and neonates who died or nearly died, 175 (39%) delivered at locations
      unable to provide basic emergency services. CONCLUSION: Access to emergency
      obstetric and neonatal care was distributed inequitably across these districts,
      suggesting the need to revisit geographic placement of facilities relative to
      population. The study also raised the question of how to ensure facilities are
      equipped to respond to emergencies.
CI  - (c) 2019 International Federation of Gynecology and Obstetrics.
FAU - Kaselitz, Elizabeth
AU  - Kaselitz E
AD  - Department of Global REACH, University of Michigan Medical School, Ann Arbor, MI,
      USA.
FAU - James, Katherine H
AU  - James KH
AD  - Department of Learning Health Sciences, University of Michigan Medical School,
      Ann Arbor, MI, USA.
FAU - Aborigo, Raymond A
AU  - Aborigo RA
AD  - Navrongo Health Research Centre, Navrongo, Ghana.
FAU - Agorinya, Isaiah
AU  - Agorinya I
AD  - Navrongo Health Research Centre, Navrongo, Ghana.
FAU - Moyer, Cheryl A
AU  - Moyer CA
AD  - Department of Global REACH, University of Michigan Medical School, Ann Arbor, MI,
      USA.
AD  - Department of Learning Health Sciences, University of Michigan Medical School,
      Ann Arbor, MI, USA.
AD  - Department of Obstetrics & Gynecology, University of Michigan Medical School, Ann
      Arbor, MI, USA.
FAU - Williams, John
AU  - Williams J
AD  - Navrongo Health Research Centre, Navrongo, Ghana.
LA  - eng
GR  - Ghana Mission of the United States Agency for International Development
GR  - Navrongo Health Research Centre and the University of Michigan
PT  - Journal Article
DEP - 20190315
PL  - United States
TA  - Int J Gynaecol Obstet
JT  - International journal of gynaecology and obstetrics: the official organ of the
      International Federation of Gynaecology and Obstetrics
JID - 0210174
OTO - NOTNLM
OT  - BEMONC
OT  - CEMONC
OT  - Facility delivery
OT  - Geo-location
OT  - Ghana
OT  - PREMAND
OT  - Skilled providers
EDAT- 2019/03/16 06:00
MHDA- 2019/03/16 06:00
CRDT- 2019/03/16 06:00
PHST- 2018/06/21 00:00 [received]
PHST- 2018/10/29 00:00 [revised]
PHST- 2019/03/13 00:00 [accepted]
PHST- 2019/03/16 06:00 [pubmed]
PHST- 2019/03/16 06:00 [medline]
PHST- 2019/03/16 06:00 [entrez]
AID - 10.1002/ijgo.12803 [doi]
PST - aheadofprint
SO  - Int J Gynaecol Obstet. 2019 Mar 15. doi: 10.1002/ijgo.12803.