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other·pediatrics, public health, family medicine, epidemiology, observational study·PMC10552361

Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana

BMC Pediatrics · 4 authors, 3 centres

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TL;DR

This qualitative study used interviews with families, healthcare professionals, and managers to identify health-system factors affecting care coordination for low-birth-weight infants in Ghana. It found that while professionals recognize the need for linked care, transitions are hampered by procedural, administrative, logistical, infrastructural, and socio-economic barriers.

Full summary

304 CHARS

Data from 25 interviews (with 11 family members, 9 healthcare professionals, and 7 managers) were analyzed to develop a theoretical model. Barriers included insufficient investments, limited training, and multiple procedural and logistical challenges that hampered smooth transitions between care levels.

STUDY TYPE

other

SPECIALTY

pediatrics

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10552361

Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana

BMC Pediatrics

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ABSTRACT

Abstract Background Low birth weight (LBW) is associated with short and long-term consequences including neonatal mortality and disability. Effective linkages in the continuum of care (CoC) for newborns at the health facility, community (primary care) and home care levels have a high tendency of minimizing adverse events associated with LBW. But it is unclear how these linkages work and what factors influence the CoC process in Ghana as literature is scarce on the views of health professionals and families of LBW infants regarding the CoC. Therefore, this study elicited the drivers influencing the CoC for LBW infants in Ghana and how linkages in the CoC could be strengthened to optimize quality of care. Methods A constructivist grounded theory study design was used. Data was collected between September 2020 to February 2021. A total of 25 interviews were conducted with 11 family members of LBW infants born in a secondary referral hospital in Ghana, 9 healthcare professionals and 7 healthcare managers. Audio recordings were transcribed verbatim, analyzed using initial and focused coding. Constant comparative techniques, theoretical memos, and diagramming were employed until theoretical saturation was determined. Results Emerging from the analysis was a theoretical model describing ten major themes along the care continuum for LBW infants, broadly categorized into health systems and family-systems drivers. In this paper, we focused on the former. Discharge, review, and referral systems were neither well-structured nor properly coordinated. Efficient dissemination and implementation of guidelines and supportive supervision contributed to higher staff motivation while insufficient investments and coordination of care activities limited training opportunities and human resource. A smooth transition between care levels is hampered by procedural, administrative, logistics, infrastructural and socio-economic barriers. Conclusion A coordinated care process established on effective communication across different care levels, referral planning, staff supervision, decreased staff shuffling, routine in-service training, staff motivation and institutional commitment are necessary to achieve an effective care continuum for LBW infants and their families. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-023-04330-5. Keywords: Continuum of care, Coordination of care, Delivery of health care, Ghana, Constructivist grounded theory, Low birth weight, Newborn care, Neonatal nursing

CITATION EXPORT

Christina Schuler, Faith Agbozo, George Edward Ntow et al.. Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana. BMC Pediatrics. (2023). https://doi.org/10.1186/s12887-023-04330-5

AUTHORS

4 · 3 CENTRES

Christina Schuler, Faith Agbozo, George Edward Ntow, Veronika Waldboth

1School of Health Sciences, Institute of Nursing, Zurich University of Applied Sciences (ZHAW), Winterthur, Switzerland
2FN Binka School of Public Health, Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
3Dodowa Health Research Centre, Dodowa, Ghana