Background: In Ghana, a universal free delivery policy was implemented
to improve access to delivery care in health facilities, thereby
improving access to skilled attendance and reducing maternal mortality.
Objective: A confidential enquiry was conducted to ascertain if changes
had occurred in the care provided by reviewing the care given to a
sample of maternal deaths before and after introduction of the policy.
Method: Twenty women who died as a result of pregnancy-related
complications (maternal deaths) in selected hospitals in two regions
were assessed by a clinical panel, guided by a maternal death assessment
form. Unlike the traditional confidential enquiry process, both adverse
and favourable factors were identified.
Findings: Clinical care provided before and after the introduction of
the fee exemption policy did not change, though women with complications
were arriving in hospital earlier after the introduction of the policy.
On admission, however, they received very poor care and this, the
clinical panel deduced could have resulted in many avoidable deaths; as
was the case before the implementation of the policy. Consumables, basic
equipment and midwifery staff for providing comprehensive emergency
obstetric care were however found to be usually available.
Conclusion: Our findings suggest that the already poor delivery care
services women received remained unchanged after introduction of the
Hospital-based maternity care in Ghana: findings of a confidential enquiry into maternal deaths. Ghana Medical Journal, 41 (3), 125-132.
Hospital based maternity care in Ghana - findings of a confidential enquiry into maternal deaths.