There is great concern about the increasing rise in the rate of caesarean section in both developed and developing countries. This study was to ascertain the prevalence and compare outcomes of elective and emergency caesarean sections among women who deliver at the University of Cape Coast Hospital, Ghana. This retrospective study reviewed records of 645 women who delivered through caesarean sections during the period of January 2014 and December 2015. The prevalence of caesarean section was 26.9%. There was a significantly higher rate of adverse fetal outcomes (P=0.016) among babies born through emergency caesarean section. There were 12 (1.9%) women who had caesarean section done based on maternal request. The caesarean section rate found in this study was high. The lack of availability of technology for diagnosing fetal distress found in this study could possibly lead to over diagnosis of fetal distress. Thus availability of such diagnostic technology could reduce the high caesarean section rate. The high numbers of women requesting caesarean section without medical indication should be investigated and the motivation factors identified so as to curb the practice.
Background: Medical emergencies are common but Sudden Cardiac Arrest (SCA) incidences are rare; yet when they occur could be life threatening leading either to disability or death. During SCA incidents, health care professionals will be required to act skilfully and swiftly to restart the heart and stabilise the patient until advanced care can be accessed or provided. There is evidence that victims of cardio and/or respiratory arrest whilst in the hospital will have improved outcomes if Cardiopulmonary Resuscitation (CPR) is initiated within three to five minutes. The objectives of this study were to find if emergency nurses were adequately resourced to practice Basic Life Support (BLS), and the ease or difficulties with which they practice BLS. Methods: This Qualitative Descriptive (QD) study was conducted at the University of Cape Coast Hospital (UCCH) between June and September 2019. Six nurses were purposively recruited for the study. All interviews were audio-recorded and transcribed verbatim. The transcription was done with Microsoft Word and transferred to Microsoft Excel for thematic analysis using an inductive descriptive approach. Data analysis took a conventional qualitative content analysis approach. Results: Four of the participants were females whilst two were males. During data aggregation and analysis, 17 first-level codes were extracted from which two themes, five categories and six subcategories were obtained for discussion. The major themes were: (1) Basic Life Support (BLS) equipment and material resources, and (2) working environment and human resource. Conclusion: The study found that nurses working at emergency ward at UCCH were adequately resourced and well prepared to practice BLS. They however had challenges as their work seem to be hindered by patients who present to the ward without emergency needs and unavailability of emergency drugs.
Background: Access to a doctor, nurse, or a midwife during childbirth is key to the global effort to reduce maternal mortality ratios. Ghana has recorded significant improvements in maternal care over the past three decades. However, despite many policies aimed at improving health care for pregnant women such as the free maternal care policy, many Ghanaian women still deliver without a skilled birth attendant present. This systematic review, therefore, sought to identify the various factors affecting utilisation of skilled birth attendance in Ghana. Methods: PubMed Central, African Journals Online (AJOL), CINAHL Plus with Full Text (EBSCO), and Science Direct were searched for studies from January 2010 to December 2020. A broad range of search terms was used. Studies included had diverse designs, were conducted among Ghanaian pregnant women, and had skilled delivery as an outcome of interest. The quality of studies was assessed. Due to the diversity of types of studies included in this systematic review (including qualitative, descriptive, and evaluative studies that ranged from simple bivariate analyses to complex multivariate modelling), a meta-analysis was neither possible nor appropriate. We, therefore, conducted a narrative synthesis of the search findings. Results: Twenty-four (24) studies met our inclusion criteria for this review. Included studies comprised sixteen (16) cross-sectional studies and eight (8) qualitative studies. The sample size of the included studies cumulatively was 86,998 participants. The emerging themes were: health system factors (10); maternal and family factors (5); and sociodemographic factors (9). Conclusion: In general, health system factors; maternal and family factors; and sociodemographic factors were found to influence skilled delivery services in Ghana. Therefore, in order to ensure that there is a skilled birth attendant present at every birth, efforts should aim at addressing social and cultural factors which have been identified as key determinants to utilisation of skilled delivery in Ghana.
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