Constraints preventing health care providers from providing quality care to their clients in Kumasi Metropolis .

Since the Alma Ata Declaration in 1978, where the international community committed itself to providing Health for all by the year 2000 through Primary Health Care (PHC), major efforts have been made in most developing countries to expand health care services. This was done through increased resource allocation to the health sector. The improvement in health status however was not commensurate with the resources expended (Browne et al.1995). For too long, commitment to improving quality health care has remained rhetorical in many developing countries especially in Sub-Saharan Africa, and poor quality health services are still the only option for many communities in this region. Further, mass education, mass media and mass consumerism have boomed in the 21st century, pulling pressure on health care providers to meet rising public expectation. In 1994, the Eastern Regional Health Directorate instituted a set of quality indicators to monitor the quality of health service so as to help improve the quality of health care (Offei et al. 1995). Health care providers are often blamed for the poor quality of health services and often asked to do more to improve services for their clients. However long standing quality problem of health professionals manifesting as lack of motivation and discontent with their work situation are relatively ignored dimensions of the problem of quality of health care in Ghana (Agyepong et al. 2001). The health care providers may have some good reasons or real constraints why they are unable to provide quality service to their clients. This study was conducted to determine some of the constraints that prevent health care providers from providing quality care to their clients in the Kumasi Metropolis. Three Government hospitals were selected at random for the study. Questionnaires were administered to 100 providers who were selected using the convenience method of sampling. Three different Focus Group Discussions (FGD) were held one in each of the three hospitals where this study was conducted. Nurses and Paramedical Staffs (8-10 in number) were selected for the FGD. Key informant interviews were also held with selected Doctors. Finding indicated that the prescribers who sit in consulting rooms attend to an average of 65 clients during morning shift making that individual seem overworked. The workload analysis however showed that the prescribers would not have been overworked if most prescribers were present to consult during the heavy clinic hours. Lack of residential accommodation, inadequate remuneration, delayed promotion and inadequate in-service training as well as transportation problems were identified as some of the constraints facing health care providers in the Kumasi Metropolis. Basic equipment are also lacking. However, the interpersonal relationship between superiors and their subordinates is largely cordial. It was recommended that the Hospital Management Team (HMT) should create flexible work schedules so that enough prescribers can consult during the heavy clinic hours. Management should also ensure that prescribers are at post to perform their duties. The HMT could engage the services of a public transport to convey workers to and from work. To alleviate the accommodation problems, a revolving fund should be set up from which loans can be given to staff to rent accommodation and pay at very low interest rates. And for a long-term solution, staff quarters should be built using IGF.

Source: KNUST