My last field assignment took me to West Africa where I was tasked with evaluating rural access to health care in Ghana. Specifically, I evaluated their National Health Insurance Scheme (NHIS), a government initiative to meet health related Millennium Development Goals and to address the public health crisis of soaring infant mortality rates.
During my three month field assignment in Accra, I served as principle Health Researcher and Monitoring and Evaluation Officer for the Participatory Monitoring and Evaluation Programme, commissioned by Ghana Health Services (GHS) and jointly executed by SEND Ghana and the Alliance for African Women Initiative (AFAWI), two Ghanaian owned and operated NGO’s who commissioned my research. My duties were far reaching and varied in scope and capacity, allowing me to work closely with GHS staff, CHO’s and the community itself.
This afforded me a greater understanding of some of the public’s barriers to accessing health care, which I’ve attempted to illustrated with real life examples drawn from my conversations with community members in Ga East, in the outskirts of Accra. Their testimonials, often harrowing, paint a bleak picture of the reality of rural life and of living in under serviced communities often forgotten by a government who’s resources often favor wealthier urban communities.
The excerpt offered below is part of my dissertation on my field work which was published by Rutgers University in New Jersey, and was awarded the best essay in global studies. Read the full essay here.
Excerpts from my Field Work:
The largest complaint from residents is receiving no treatment when they went to the hospital and were consequently referred elsewhere for treatment. One woman we spoke to was turned away from the hospital when she was in labour:
“No midwife was available at the time and we were referred to the hospital. There was no ambulance to take me so we took a tro tro (a shared bus, public transportation) and I ended up giving birth on the way.”
Another female resident, who was pregnant at the time of this interview, broke down in tears when asked about her experience at the hospital:
“My first child was ill, he had a terrible fever and we went to the hospital to see a doctor but all they gave him was first aid. They said there was no nurse available, and they didn’t have the equipment we needed. They referred us to Ridge Hospital but my child died before we could get there.”
The second biggest complaint from residents was the poor service they received. Many stories were recorded of nurses being rude, inattentive and even negligent. One woman recounts her experience of giving birth at Abokobi Hospital:
“During my childbirth the nurse was forceful and hitting me to push harder. The nurse was scolding me and unhappy with me and walks out midway, I had to finish the birth alone without anyone but the cleaner that was in the room and she had to hold my baby with no gloves on.”
One woman spoke of having to wait to be seen while in labour and the poor service she received from the nurse on duty at the time:
“I was in labour and went to the hospital but when I got there the nurse said her shift ended and would not help. Had to wait two hours for another nurse to come. Then the power went off and there was no generator.”
Another woman we interviewed had a similar story of long waiting times and negligent nurses:
“My son was very ill but the nurse’s shift ended and wouldn’t help him but she stayed and read a book in the corner. We hurried to private hospital. I heard that the facilities are better now but I don’t want to risk going back. I heard too many bad stories from neighbors.”
Many other residents had severe complaints about substantial mistakes that health workers made at the hospital, and many were unhappy with the quality of drugs they received. One woman said she was given the wrong medication for her illness and claims she almost died as a direct result. A man said that his son developed an abscess after a vaccination was administered wrongly and is left permanently crippled. Another woman claims to have received painkillers for malaria and no first aid for a head injury, and was referred to another hospital for both these emergencies.
Maria Polychronis 