Developing Acute Care and Emergency Referral Systems (ACERS)

Olufemi Olatidoye, VP&S Class of 2025

Name: Olufemi Olatidoye
School: Vagelos College of Physicians & Surgeons, Class of 2025, Varmus Global Scholar 2022
Mentor: Rachel Moresky, MD, MPH and Mohammed Ali, PhD, MPH

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While Ghana has a well-organized healthcare system, there are opportunities to strengthen the continuum of care throughout the emergency obstetric and neonatal care (EmONC) system to increase maternal and neonatal health outcomes. The Developing Acute Care and Emergency Referral Systems (ACERS) project seeks to address gaps in the delivery of high-quality EmONC in Ghana’s Northern and Oti regions by leveraging implementation science to shape evidence-based national policies and strategies. The ACERS project employs a variety of interventions with the aim of increasing community demand generation for care, strengthening dispatch and timely referral, and improving quality of care. An objective of this practicum was to conduct ongoing assessments of ACERS interventions and provide recommendations for increasing the acceptability and feasibility of the ACERS facility-based intervention package, which focuses on increasing the competence of health workers to provide EmONC services. Semi- structured interviews with health workers, facility appraisals at Community-Based Health Planning and Services (CHPS) compounds, and analysis of routine data showed that Helping Mothers Survive (HMS) and Helping Babies Breathe (HBB) training programs were successful in increasing health workers’ ability to conduct EmONC signal functions. CHPS community scorecard data also confirmed that facilities are performing well, but this data has not been captured regularly. Furthermore, health workers reported experiencing major challenges with facility equipment such as malfunctioning delivery beds, inappropriate ambu-bags, and a lack of essential medicines. Future strategies for increasing quality EmONC services must include procurement of necessary medical equipment and an emphasis on consistent community feedback via the adapted community scorecard.