Filiations 1 Department of Pharmacy, Noakhali Science and Technologies University, Noakhali, Bangladesh two College of

Filiations 1 Department of Pharmacy, Noakhali Science and Technologies University, Noakhali, Bangladesh two College of Pharmacy, Monash University Malaysia, Selangor, Malaysia 3 Unit for Medication Outcomes Analysis and Education (UMORE), Pharmacy, College of Medicine, University of Tasmania, Hobart, Tasmania, Australia four KIN1408 Vector-borne Ailments Research Group (VERDI), Faculty of Pharmacy, Universiti Teknologi PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21331531 MARA (UiTM), Puncak Alam, Malaysia Acknowledgements
^^Open AccessResearchCompetence of overall health workers in emergency obstetric care: an assessment making use of clinical vignettes in Brong Ahafo area, GhanaTerhi Johanna Lohela,1,two Robin Clark Nesbitt,2 Alexander Manu,three,four Linda Vesel,5,six Eunice Okyere,7,eight Betty Kirkwood,3 Sabine GabryschTo cite: Lohela TJ, Nesbitt RC, Manu A, et al. Competence of health workers in emergency obstetric care: an assessment working with clinical vignettes in Brong Ahafo region, Ghana. BMJ Open 2016;six:e010963. doi:ten.1136bmjopen-2015010963 Prepublication history for this paper is available on-line. To view these files please pay a visit to the journal online (http:dx.doi.org10.1136 bmjopen-2015-010963). Received 23 December 2015 Revised 22 April 2016 Accepted 27 AprilABSTRACT Objectives: To assess well being worker competence inemergency obstetric care using clinical vignettes, to link competence to availability of infrastructure in facilities, and to typical annual delivery workload in facilities. Design: Cross-sectional Overall health Facility Assessment linked to population-based surveillance data. Setting: 7 districts in Brong Ahafo area, Ghana. Participants: Most skilled delivery care providers in all 64 delivery facilities inside the 7 districts. Main outcome measures: Health worker competence in clinical vignette actions by cadre of delivery care provider and by kind of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Final results: Vignette scores have been moderate overall, and differed considerably by respondent cadre ranging from a median of 70 correct amongst medical doctors, by means of 55 among midwives, to 25 among other cadres such as health assistants and wellness extension workers ( p0.001). Competence varied substantially by facility sort: hospital respondents, who were mainly doctors and midwives, achieved highest scores (70 correct) and clinic respondents scored lowest (45 appropriate). There was a lack of cheap key drugs and equipment to carry out vignette actions, and much more normally, lack of competence to use available items in clinical conditions. The average annual workload was pretty unevenly distributed amongst facilities, ranging from 0 to 184 deliveries per skilled birth attendant, with greater workload associated with larger vignette scores. Conclusions: Lack of competence may well limit clinical practice even more than lack of relevant drugs and gear. Cadres apart from midwives and physicians might not be able to diagnose and handle delivery complications. Checking clinical competence by way of vignettes along with checklist products could contribute to a additional complete strategy to evaluate high quality of care. Trial registration quantity: NCT00623337.Strengths and limitations of this studyWe used clinical vignettes to assess well being worker competence in rural Ghana, choosing two major causes of maternal mortality that independently functioning delivery care experts ought to be capable to diagnose and manage. Even though not nationally or longitudinally re.