Training for clinic doctors sees instant results in Ghana


Dr. Srofenyo (in the blue shirt) leads a training for clinic doctors on how to determine if a patient is in need of emergency obstetric care.
Dr. Emmanuel Srofenyo noticed a serious problem at Ridge Hospital and the clinics in the surrounding region of Ghana. The maternal and newborn morbidity and mortality rate was already too high and was increasing. An obstetrician gynecologist, Dr. Srofenyo found that most general practice doctors only checked on their patients in the labor ward once a day, or when the midwives called them to do a caesarian section. He noticed a strained relationship between the doctors and midwives. In addition, some of the staff at the clinics did not have the training to deal with emergency cases. Women in labor with time-sensitive health issues were often sent from the clinics to the hospital, instead of being treated immediately. This time lapse in treatment decreased some of the women's chances of recovery and put their newborns' lives in danger.

To address these issues, Dr. Srofenyo, along with USAID's Focus Region Health Project (FRHP), implemented by JSI Research & Training Institute, Inc., and Ridge Hospital, set up the emergency obstetric and neonatal care (EmONC) training for general practice doctors working in health clinics around the region. Over ten days, the participating doctors took part in practical skills development focused on updating their knowledge of maternal and newborn care and training on case triaging. Case triaging involves quickly assessing patients at the clinics or emergency unit and determining the order in which they are treated to ensure that the most urgent cases are seen first. In addition, Dr. Srofenyo demonstrated good leadership skills to the doctors, to be used to motivate their staff to work better in challenging circumstances, as well as to develop better relationships with the midwives.

Dr. Srofenyo saw immediate results. The participating doctors responded enthusiastically to all aspects of the training and were excited to put everything they had learned into effect in their clinics. They especially enjoyed case triaging, something they had never done before. The physicians were committed to implementing case triaging in their facilities to better treat emergency patients at the clinics, rather than immediately referring them to Ridge Hospital. One doctor stated that she had gained great knowledge at this training, and while she was disappointed in how she had managed some cases in the past, she now had the confidence and the skills to manage those cases differently in the future. A few weeks after the training, another participant, Dr. Vuado, said, "The number of cases we refer to Ridge Hospital has dropped over 60% since I returned from this training. Also, I am providing better leadership in the management of obstetric cases. I have met most of the midwives in the district to discuss how to improve maternal care…and have developed more cordial relationships with the midwives. The training has greatly improved my overall performance."

Dr. Srofenyo was very pleased with the results of the program, and has goals to continue the trainings and turn Ridge Hospital and the surrounding clinics into a center of excellence for EmONC.