Aaron Asibi Abuosi

Patients versus healthcare providers’ perceptions of quality of care: Establishing the gaps for policy action

Purpose – The purpose of this paper is to find out whether there are any significant gaps in perceptions of quality of care between patients and healthcare providers in Ghana’s hospitals. Design/methodology/approach – A cross-sectional survey of patients seeking outpatient consultations in 17 general hospitals in Ghana was conducted. A total of 818 patients and 152 hospital managers were interviewed. A 22-item quality of care scale was used in data collection. Data were analysed with the aid SPSS version 20. Summary statistics and t-test were used to analyse the data. Findings – There was a significant difference in the overall perception of quality of care between patients and healthcare providers (Patients: M=89.11, SD=11.457; Providers: M=94.60, SD=10.922; t (845) −4.956, p < 001, two-tailed). Also, 18 items out of the 22-item quality of care scale showed significant difference between patients and providers. However, levels of quality of care is generally rated fairly favourably by both category of respondents. Research limitations/implications – Further study is required to explore the reasons for the perceived quality gaps between patients and healthcare providers. Practical implications – Management of hospitals need to evaluate patients’ perceptions of quality of care to inform measures aimed at improving quality of care, since what they may consider as good quality service may be rated less favourably by patients. Originality/value – Comparing perceptions of quality between patients and healthcare providers is important in order adopt measures to address any differences in perceptions of quality between the two stakeholders. To the best of the author’s knowledge no study has been conducted in Ghana to that effect.

Maternal Socio-economic Status and Childhood Birth weight: A Health Survey in Ghana

Low birth weight (LBW) is one of the key reproductive health indicators whose outcome is influenced by consumption of reproductive health care. Rosenzweig and Schultz (1983) argue that one of the key measures of child health is that of birth weight. Birth weight is a good gauge of health of the child in the womb because the weight is taken immediately after birth. Consequently, a malnourished fetus will be born at low birth weight. On average, the worldwide incidence of low birth weight varies among countries, ranging from 4% to 6% in western countries like Sweden, France, United States and Canada (UNICEF 2003). Nevertheless, LBW is prevalent in developing countries especially those in the Sub-Saharan region due to the high levels of malnutrition and infectious diseases. A child’s birth weight is an important indicator of the child’s vulnerability to the risk of childhood illnesses and the chances of survival. Sub-Saharan Africa (SSA) has the second highest incidence of low birth weight infants the world over (16%), with South Central Asia being the highest at 27% (UNICEF and WHO 2004). The most recent evidence on Ghana shows that approximately 10% of all births are LBW (GSS, 2009). In particular, the UN envisages a reduction of low birth weight by at least one-third in the proportion of infants. This target is in fact, one of the seven major goals for the current decade of the “A World Fit for Children” programme of the United Nations (UN, 2004).

Health insurance and quality of care: Comparing perceptions of quality between insured and uninsured patients in Ghana’s hospitals

BackgroundThe introduction of health insurance in Ghana in 2003 has resulted in a tremendous increase in utilization of health services. However, concerns are being raised about the quality of patient care. Some of the concerns include long waiting times, verbal abuse of patients by health care providers, inadequate physical examination by doctors and discrimination of insured patients. The study compares perceptions of quality of care between insured and uninsured out-patients in selected hospitals in Ghana to determine whether there is any unequal treatment between insured and uninsured patients in terms of quality of care, as empirical and anecdotal evidence seem to suggest.MethodsA cross-sectional survey of 818 out-patients was conducted in 17 general hospitals from three regions of Ghana. These are the Upper East, Brong Ahafo and Central Regions. Convenience sampling was employed to select the patients in exit interviews. Descriptive statistics, including frequency distributions, means and standard deviations, were used to describe socio-economic and demographic characteristics of respondents. Factor analysis was used to determine distinct quality of care constructs; t-test statistic was used to test for differences in quality perceptions between the insured and uninsured patients; and regression analysis was used to test the association between health insurance and quality of care.ResultsOverall, there was no significant difference in perceptions of quality between insured and uninsured patients. However, there was a significant difference between insured and uninsured patients in respect of financial access to care. The major quality of care concern affecting all patients was the problem of inadequate resources, especially lack of doctors, lack of drugs and other basic supplies and equipment to work with.ConclusionsIt was concluded that generally, insured and uninsured patients are not treated unequally, contrary to prevailing anecdotal and empirical evidence. On the contrary, quality of care is a concern of both insured and uninsured patients.

Educational status and beliefs regarding non-communicable diseases among children in Ghana

BackgroundIncreasing prevalence of non-communicable diseases (NCDs) has been observed in Ghana as in other developing countries. Past research focused on NCDs among adults. Recent researches, however, provide evidence on NCDs among children in many countries, including Ghana. Beliefs about the cause of NCDs among children may be determined by the socioeconomic status of parents and care givers. This paper examines the relationship between educational status of parents and/or care givers of children with NCDs on admission and their beliefs regarding NCDs among children.MethodsA total of 225 parents and/or care givers of children with NCDS hospitalized in seven hospitals in three regions (Greater Accra, Ashanti and Volta) were selected for the study. Statistical techniques, including the chi-square and multinomial logistic regression, were used for the data analysis.ResultsEducational status is a predictor of care giver’s belief about whether enemies can cause NCDs among children or not. This is the only belief with which all the educational categories have significant relationship. Also, post-secondary/polytechnic (p-value =0.029) and university (p-value = 0.009) levels of education are both predictors of care givers being undecided about the belief that NCDs among children can be caused by enemies, when background characteristics are controlled for. Significant relationship is found between only some educational categories regarding the other types of beliefs and NCDs among children. For example, those with Middle/Juniour Secondary School (JSS)/Juniour High School (JHS) education are significantly undecided about the belief that the sin of parents can cause NCDs among children.ConclusionsEducation is more of a predictor of the belief that enemies can cause NCDs among children than the other types of beliefs. Some categories of ethnicity, residential status and age have significant relationship with the beliefs when background characteristics of the parents and/or care givers were controlled for.

Non-communicable diseases among children in Ghana: health and social concerns of parent/caregivers.

BACKGROUND Globally, there is a progressive rise in the burden of non-communicable diseases (NCDs). This paper examined the health and social concerns of parents/caregivers on in-patient care for children with NCDs in Ghana. METHODS This was a cross-sectional study in three large health facilities in Ghana (the largest in the South, the largest in the North and the largest in the Eastern part of Ghana. Data was collected with a structured questionnaire among 225 caregivers (≥18 years) of 149 children with NCDs in health facilities in the three regions. Data was analyzed with simple descriptive statistics. RESULTS Most caregivers 169(75.0%) were women, relatively young (median age 35years), mostly married and resided in urban areas. Sickle cell disease was the commonest NCD among the children. All 169(75.0%) caregivers believed children suffer NCDs because of sins of parents/ancestors, 29(12.9%) believed herbalists/spiritualists have insights into treating NCDs and 73(32.6%) have previously used herbs/traditional medicine for childs illness. NCD in children was a burden and caused financial difficulties for families. Most caregivers (>96.0%) indicated NCDs in children should be included in national health insurance benefits package and a comprehensive national NCD policy is needed. CONCLUSION Absence of national NCD policy for children is a major challenge. The burden of care rests mainly on the parents/caregivers. A national strategic intervention on the importance of awareness generation on the causes, risk factors, prevention and treatment of NCDs for families and communities is essential. Government support through national health and social policy initiatives are essential.