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Strengthening Emergency Obstetric and Newborn Care: Key to achieving zero maternal and neonatal deaths in Ghana

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By Antoinette Abbah

Access to Emergency Obstetric and Newborn Care, EmONC, is crucial in changing the face of maternal and neonatal healthcare in Ghana. These critical services are essential for managing life-threatening complications, significantly reducing maternal and neonatal mortality rates. As Ghana works toward achieving its Sustainable Development Goals in health, strengthening EmONC services has become a key priority, offering hope to countless families across the country. Limited access to quality EmONC in rural and underserved areas further exacerbate the risk for mothers and newborns. Additionally, only 4% of health centers are equipped to provide basic EmONC services, a decrease from 7% in 2010, pointing to a significant gap in essential healthcare infrastructure. Coordination across different levels of care remains inconsistent, causing delays in treatment and insufficient support for patients. Fragmented referral systems between health centers and higher-level facilities also hinder the timely and effective transfer of patients requiring specialized care. These challenges lead to a lack of timely and effective care, negatively impacting the overall quality of maternal and newborn healthcare services.

In response to these challenges and as part of its ongoing commitment to enhancing healthcare, the Ghana Health Service, with support from the United Nations Population Fund UNFPA, has organized a three-day Capacity training workshop on EmONC, at Koforidua in the Eastern Region. This training, which brought together some healthcare professionals across the Oti, Volta, and Eastern regions, aimed to bolster the Networks of Practice and improve the competencies of healthcare personnel in maternal and neonatal care.

Speaking at a workshop, Maternal Health Thematic Health Consultant, UNFPA, Dr Divine Atupra, said the training is designed to be interactive and develop effective referral pathways at all levels of the healthcare system. He stressed the importance of moving away from the traditional gatekeeper system, which often creates barriers to care. Dr. Atupra also highlighted the need to identify challenges at every level of healthcare, from primary to tertiary, and find practical solutions to address them. He said it is crucial to continue building capacity at all levels of the system to ensure a more responsive and efficient healthcare network for maternal and newborn care, “It’s really important to keep building capacity at all levels of the healthcare system to make it more responsive and efficient, ensuring better care for moms and babies. This can be done by creating a strong network of practice where healthcare workers work together and share knowledge to improve care across the board,” – Dr. Atupra said.

Deputy Director in Charge of Policy at the Policy, Planning, Monitoring, and Evaluation Division of the Ghana Health Service, Dr. Andrew Ayim, underscored the importance of effective leadership in strengthening EmONC and fostering a robust Network of Practice, NoP. He said leadership requires courage to make bold decisions and inspire positive change within teams. According to Dr Ayim, good leaders must also demonstrate strong character, showing integrity and trustworthiness in their actions, while being compassionate and displaying genuine care for the people they serve. He further stressed the need to leverage the principles of NoP to design targeted and life-saving interventions, driven by a thorough understanding of district-level data adding that efforts to strengthen EmONC and NoP must be inclusive, ensuring that no one is left behind in the pursuit of improved healthcare outcomes. “We need to use the principles of NoP to create targeted, life-saving solutions, backed by a solid understanding of district-level data. It’s important that efforts to strengthen EmONC and NoP are inclusive, making sure no one gets left behind in improving healthcare for everyone. By focusing on these areas, we can make sure that even the most vulnerable get the care they need and drive real, lasting change,”Dr Ayim stressed.

Regional Perspectives on Healthcare Challenges and Progress

A representative of the Eastern Region and a Medical Superintendent of Nsawam Hospital, Dr. Kwabena Awuku said while some facilities in the region have made strides in infrastructure, human resource development, and community engagement, there is the need to modernize most facilities to meet growing healthcare demands. “We’ve made progress, but the modernization of our facilities remains a challenge. Healthcare is a shared responsibility; by working together, we can transform the facilities.” Dr Awuku noted.

In a presentation on behalf of the Volta Region, Chief Midwifery and Nursing Officer, Faustine Asante, identified the inadequate ratio of Physician Assistants, PAs and midwives to patients as a major challenge, alongside a lack of essential delivery equipment such as delivery sets and kits. These issues, she said, hinder the delivery of quality maternal and neonatal care. Despite these challenges, Ms. Asante noted promising opportunities for improvement. “Training programs could be expanded to increase the quota of skilled healthcare providers, while conducting needs assessments would ensure hospitals and clinics receive the specific resources required to operate efficiently. To address these issues, she emphasized the need for capacity building, particularly for staff who have never attended any form of professional training. Equipping our workforce with the right skills is critical to improving quality healthcare delivery in the region,” she said.

A Physician Assistant in the Guan District of the Oti Region, Eric Agboka, has expressed concerns about critical gaps in the district’s healthcare system. He highlighted that many facilities lack sufficient personnel, with most operating with fewer than two midwives. This shortage, he noted, has a direct impact on the quality of maternal and child healthcare services in the district. In addition to staffing challenges, Mr. Agboka pointed out the insufficient supply of essential medicines at the sub-district level. “These shortages create significant difficulties for healthcare providers, who struggle to meet the needs of their patients. He emphasized that a reliable supply of medicines is critical to improving healthcare delivery and outcomes in the area. We need a regional medical store to ensure the consistent distribution of medicines and medical supplies. The medical store combined with efforts to recruit and retain more healthcare personnel, could significantly strengthen the healthcare system in the Guan District and the Oti Region as a whole”, he noted.

With continued commitment, collaboration, and targeted action, Ghana can overcome these challenges and build a healthcare system that ensures every mother and newborn receives the needed care they deserve.

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