ABSTRACT
INTRODUCTION: Emergency care is an essential component of health systems, particularly in low- and middle-income countries. We sought to assess the availability of resources to provide emergency care at a second-level hospital in Ghana. By doing so, deficits that could guide development of targeted intervention strategies to improve emergency care could be identified. METHODS: A qualitative and quantitative assessment of capacity for care of emergency patients was performed at the Emergency Centre of the Police Hospital, a second-level hospital in Accra, Ghana. Direct inspection and job-specific survey of clinical, orderly, administrative and ambulance staff was performed. Responses to quantitative questions were described. Qualitative responses were examined by content analysis. RESULTS: Assessment revealed marked deficiencies in many essential items and services. However, several successes were identified, such as laboratory capacity. Among the unavailable essential items, some were of low-cost, such as basic airway supplies, chest tubes and several emergency medications. Themes from staff responses when asked how to improve emergency care included: provide periodic training, increase bed numbers in the emergency unit, ensure availability of essential items and make personal protective equipment available for all staff caring for patients. CONCLUSION: This study identified opportunities to improve the care of patients with emergency conditions at the Police Hospital in Ghana. Low-cost improvements in training, organization and planning could improve item and service availability, such as: developing a continuing education curriculum for staff in all areas of the emergency centre; holding in-service training on existing protocols for triage and emergency care; adding checklists to guide appropriate triage and safe transfer of patients; and perform a root cause analysis of item non-availability to develop targeted interventions.
INTRODUCTION: Les soins d'urgence sont une composante essentielle des systèmes de santé, notamment dans les pays à faible et moyen revenus. Nous avons cherché à évaluer la disponibilité des ressources allouées aux soins d'urgence dans un hôpital de deuxième niveau au Ghana. Il serait ainsi possible d'identifier les lacunes et ainsi guider le développement de stratégies d'intervention ciblées afin d'améliorer les soins d'urgence. MÉTHODES: Une évaluation qualitative et quantitative de la capacité de prise en charge des urgences a été réalisée au sein de l'Unité accidents et urgences de l'hôpital de la Police, un hôpital de second niveau situé à Accra, au Ghana. Un examen direct et propre à la profession a été réalisé à propos du personnel soignant, administratif et ambulancier. Les réponses aux questions quantitatives ont été décrites. Les réponses qualitatives ont été examinées par une analyse de leur contenu. RÉSULTATS: L'évaluation a révélé des déficiences prononcées dans nombre d'articles et services essentiels. Cependant, plusieurs succès ont été enregistrés, tels que la capacité des laboratoires. Parmi le matériel essentiel faisant défaut, il s'agissait pour certains de matériel peu coûteux, comme les dispositifs d'alimentation des voies aériennes de base, les drains thoraciques et plusieurs traitements d'urgence. Les réponses fournies par le personnel à la question de savoir comment améliorer les soins d'urgence incluaient les thèmes suivants: l'accès à une formation périodique, l'augmentation du nombre de lits au sein des urgences, la garantie de la disponibilité du matériel essentiel, et la mise à disposition de tous les employés s'occupant des urgences d'un équipement de protection individuelle. CONCLUSION: Cette étude a identifié des opportunités d'amélioration de la prise en charge des urgences au sein de l'hôpital de la Police au Ghana. Des améliorations peu coûteuses en termes de formation, d'organisation et de planification pourraient améliorer la disponibilité du matériel et du service, telles que l'élaboration d'un programme d'enseignement médical continu dans tous les domaines du centre des urgences, la tenue d'une formation interne sur les protocoles de triage et de soins d'urgence existants, l'ajout de listes de vérification afin de permettre un triage approprié et le bon transfert des patients, et la conduite d'une analyse des causes premières de la non-disponibilité de matériel afin d'élaborer des interventions ciblées.
ABSTRACT
The goal was to evaluate the effectiveness of recent televised advertisements conducted by the National Road Safety Commission in Ghana. These concerned speeding and alcohol-impaired driving and were targeted towards commercial drivers. Focus group discussions were conducted with 50 commercial drivers in four cities. Discussions addressed coverage, clarity and appropriateness of messages, including suggestions for improvements. Most discussants indicated that the messages were clear and appropriate. Television reached all participants in this urban group. However, they felt that other modes of communication, such as flyers and radio, should also be used to reach drivers who did not own televisions. A particular problem was language. The advertisements had been in English and Akan (the most common vernacular language). Participants wanted the messages diversified into more of the major Ghanaian languages. Some participants were unclear on the behaviour that the advertisements were telling viewers to take. Participants advocated greater involvement by police in road safety and called for laws banning the sale of alcohol at bus stations. The advertisements reached and were understood by most of the target audience. Opportunities for strengthening the messages included using other media; increasing the number of languages; and stressing the change in behaviour being recommended. Overall road safety activities would be strengthened by increasing accompanying law enforcement activities related to speed and alcohol-impaired driving. To the authors' knowledge this is the first formal evaluation of a road safety social marketing programme in a low-income sub-Saharan African country. This evaluation will hopefully assist Ghana and other similar countries in strengthening road safety work.
