Description
AUTHORS: Justin Benton1, Rohit Mukherjee1, Mohammed Elrais1, Jersey Chen1, Dr. Mohammed Ali2, Cecilia Crews3, Dr. Ahmed Zakariah4, Dr. Alberta Biritwum-Nyarko5, and Dr. Rachel T. Moresky6
AUTHOR AFILLIATION: 1. Rutgers Robert Wood Johnson Medical School, Piscataway, NJ,
2. Catholic Relief Services, Tamale, Ghana, 3. Columbia Mailman School of Public Health, New York, NY, 4. National Ambulance Service, Accra, Ghana, 5. Ghana Health Service, Accra, Ghana, 6. Columbia University sidHARTe – Emergency Systems Program
FUNDING SOURCES: United States Agency for International Development
COUNTRY: Ghana
REGION: Sub-Saharan Africa
Background
The ACERS program addresses the barriers to an integrated continuum of Emergency Obstetric and Newborn Care (EmONC) delivery. Previously, patients suffering EmONC emergencies were forced to travel to health facilities by foot, motorbikes, or private vehicles. To address this gap, three-wheeled Modified Motorking Motorcycles (MMAs) were deployed across two districts in the Northern and Oti Regions of Ghana to link rural communities to health facilities. Implementers iteratively adapted the MMA program design to accommodate clients' evolving needs and expanded and adapted the fleet from 14 MMAs in October 2018 to 22 by September 2019.
Methods
A Realist Approach (RA) was used to identify key CMO (Context, Mechanism, Outcome) configurations. Adaptations to key mechanisms (physical dimension, first-aid package, trainings, maintenance regime) within target contexts (rural, underserved communities and primary health care facilities) were intended to improve transport safety, comfort, and quality of care, to ultimately achieve the desired outcome (increased facility deliveries). Our approach utilized mixed data sources including findings of two rounds of focus group discussions, field appraisals, and results of two rounds of Lot Quality Assurance Sampling.
Results
The key CMO configurations identified in response to these adversities include vehicle stability to enhance safety measures, streamlined transport to health facilities through harmonization and dispatch coordination, clinical equipment to accommodate en-route stabilization, linkage of patients to community-established emergency transport systems (CETS), and improved client acceptability of the intervention. Across the project period 2018-2022, the fleet transported 3,744 total cases. The incidence of MMA-related accidents at the baseline from October 2018 to September 2022 was reduced from four to one out of the 22 MMAs operating.
| Contact Geneva Health Forum | I would like to receive information about the GHF 2024 conference and other GHF activities / Je souhaite recevoir des informations sur la conférence GHF 2024 et d'autres activités du GHF. |
|---|
