Competence of health workers in emergency obstetric care : an assessment using clinical vignettes in Brong Ahafo region, Ghana

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Lohela , T , Nesbitt , R C , Manu , A , Vesel , L , Okyere , E , Kirkwood , B & Gabrysch , S 2016 , ' Competence of health workers in emergency obstetric care : an assessment using clinical vignettes in Brong Ahafo region, Ghana ' , BMJ Open , vol. 6 , no. 6 , 010963 . https://doi.org/10.1136/bmjopen-2015-010963

Title: Competence of health workers in emergency obstetric care : an assessment using clinical vignettes in Brong Ahafo region, Ghana
Author: Lohela, Terhi; Nesbitt, Robin Clark; Manu, Alexander; Vesel, Linda; Okyere, Eunice; Kirkwood, Betty; Gabrysch, Sabine
Contributor: University of Helsinki, Clinicum
Date: 2016
Language: eng
Number of pages: 10
Belongs to series: BMJ Open
ISSN: 2044-6055
URI: http://hdl.handle.net/10138/167135
Abstract: Objectives To assess health worker competence in emergency obstetric care using clinical vignettes, to link competence to availability of infrastructure in facilities, and to average annual delivery workload in facilities. Design Cross-sectional Health Facility Assessment linked to population-based surveillance data. Setting 7 districts in Brong Ahafo region, Ghana. Participants Most experienced delivery care providers in all 64 delivery facilities in the 7 districts. Primary outcome measures Health worker competence in clinical vignette actions by cadre of delivery care provider and by type of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Results Vignette scores were moderate overall, and differed significantly by respondent cadre ranging from a median of 70% correct among doctors, via 55% among midwives, to 25% among other cadres such as health assistants and health extension workers (p Conclusions Lack of competence might limit clinical practice even more than lack of relevant drugs and equipment. Cadres other than midwives and doctors might not be able to diagnose and manage delivery complications. Checking clinical competence through vignettes in addition to checklist items could contribute to a more comprehensive approach to evaluate quality of care.
Subject: Quality of care
Emergency obstetric care
Clinical vignettes
Signal functions
Health facility assessment
QUALITY-OF-CARE
STANDARDIZED PATIENTS
PHYSICIAN PRACTICE
CHART ABSTRACTION
NEWBORN HEALTH
MIDWIFERY
COUNTRIES
RECORD
3121 General medicine, internal medicine and other clinical medicine
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