Barriers to evidence-based acute stroke care in Ghana

A qualitative study on the perspectives of stroke care professionals

Leonard Baatiema, Ama De-Graft Aikins, Adem Sav, George Mnatzaganian, Carina K.Y. Chan, Shawn Somerset

Research output: Contribution to journalArticle

5 Citations (Scopus)
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Abstract

Objective: Despite major advances in research on acute stroke care interventions, relatively few stroke patients benefit from evidence-based care due to multiple barriers. Yet current evidence of such barriers is predominantly from high-income countries. This study seeks to understand stroke care professionals' views on the barriers which hinder the provision of optimal acute stroke care in Ghanaian hospital settings. Design: A qualitative approach using semistructured interviews. Both thematic and grounded theory approaches were used to analyse and interpret the data through a synthesis of preidentified and emergent themes. Setting: A multisite study, conducted in six major referral acute hospital settings (three teaching and three non-teaching regional hospitals) in Ghana. Participants: A total of 40 participants comprising neurologists, emergency physician specialists, non-specialist medical doctors, nurses, physiotherapists, clinical psychologists and a dietitian. Results: Four key barriers and 12 subthemes of barriers were identified. These include barriers at the patient (financial constraints, delays, sociocultural or religious practices, discharge against medical advice, denial of stroke), health system (inadequate medical facilities, lack of stroke care protocol, limited staff numbers, inadequate staff development opportunities), health professionals (poor collaboration, limited knowledge of stroke care interventions) and broader national health policy (lack of political will) levels. Perceived barriers varied across health professional disciplines and hospitals. Conclusion: Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.

Original languageEnglish
Article numbere015385
Pages (from-to)1-11
Number of pages11
JournalBMJ Open
Volume7
Issue number4
DOIs
Publication statusPublished - 1 Apr 2017
Externally publishedYes

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Ghana
Stroke
Health Policy
Health
Staff Development
Nutritionists
Physical Therapists
Quality Improvement
Administrative Personnel
Teaching
Emergencies
Referral and Consultation
Nurses
Interviews
Psychology
Physicians

Cite this

Baatiema, Leonard ; De-Graft Aikins, Ama ; Sav, Adem ; Mnatzaganian, George ; Chan, Carina K.Y. ; Somerset, Shawn. / Barriers to evidence-based acute stroke care in Ghana : A qualitative study on the perspectives of stroke care professionals. In: BMJ Open. 2017 ; Vol. 7, No. 4. pp. 1-11.
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abstract = "Objective: Despite major advances in research on acute stroke care interventions, relatively few stroke patients benefit from evidence-based care due to multiple barriers. Yet current evidence of such barriers is predominantly from high-income countries. This study seeks to understand stroke care professionals' views on the barriers which hinder the provision of optimal acute stroke care in Ghanaian hospital settings. Design: A qualitative approach using semistructured interviews. Both thematic and grounded theory approaches were used to analyse and interpret the data through a synthesis of preidentified and emergent themes. Setting: A multisite study, conducted in six major referral acute hospital settings (three teaching and three non-teaching regional hospitals) in Ghana. Participants: A total of 40 participants comprising neurologists, emergency physician specialists, non-specialist medical doctors, nurses, physiotherapists, clinical psychologists and a dietitian. Results: Four key barriers and 12 subthemes of barriers were identified. These include barriers at the patient (financial constraints, delays, sociocultural or religious practices, discharge against medical advice, denial of stroke), health system (inadequate medical facilities, lack of stroke care protocol, limited staff numbers, inadequate staff development opportunities), health professionals (poor collaboration, limited knowledge of stroke care interventions) and broader national health policy (lack of political will) levels. Perceived barriers varied across health professional disciplines and hospitals. Conclusion: Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.",
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Barriers to evidence-based acute stroke care in Ghana : A qualitative study on the perspectives of stroke care professionals. / Baatiema, Leonard; De-Graft Aikins, Ama; Sav, Adem; Mnatzaganian, George; Chan, Carina K.Y.; Somerset, Shawn.

In: BMJ Open, Vol. 7, No. 4, e015385, 01.04.2017, p. 1-11.

Research output: Contribution to journalArticle

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T1 - Barriers to evidence-based acute stroke care in Ghana

T2 - A qualitative study on the perspectives of stroke care professionals

AU - Baatiema, Leonard

AU - De-Graft Aikins, Ama

AU - Sav, Adem

AU - Mnatzaganian, George

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AB - Objective: Despite major advances in research on acute stroke care interventions, relatively few stroke patients benefit from evidence-based care due to multiple barriers. Yet current evidence of such barriers is predominantly from high-income countries. This study seeks to understand stroke care professionals' views on the barriers which hinder the provision of optimal acute stroke care in Ghanaian hospital settings. Design: A qualitative approach using semistructured interviews. Both thematic and grounded theory approaches were used to analyse and interpret the data through a synthesis of preidentified and emergent themes. Setting: A multisite study, conducted in six major referral acute hospital settings (three teaching and three non-teaching regional hospitals) in Ghana. Participants: A total of 40 participants comprising neurologists, emergency physician specialists, non-specialist medical doctors, nurses, physiotherapists, clinical psychologists and a dietitian. Results: Four key barriers and 12 subthemes of barriers were identified. These include barriers at the patient (financial constraints, delays, sociocultural or religious practices, discharge against medical advice, denial of stroke), health system (inadequate medical facilities, lack of stroke care protocol, limited staff numbers, inadequate staff development opportunities), health professionals (poor collaboration, limited knowledge of stroke care interventions) and broader national health policy (lack of political will) levels. Perceived barriers varied across health professional disciplines and hospitals. Conclusion: Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.

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KW - Quality of Health Care/statistics & numerical data

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