Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-28903
Publication type: Article in scientific journal
Type of review: Open peer review
Title: Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana
Authors: Schuler, Christina
Agbozo, Faith
Ntow, George Edward
Waldboth, Veronika
et. al: No
DOI: 10.1186/s12887-023-04330-5
10.21256/zhaw-28903
Published in: BMC Pediatrics
Volume(Issue): 23
Issue: 1
Page(s): 501
Issue Date: 5-Oct-2023
Publisher / Ed. Institution: BioMed Central
ISSN: 1471-2431
Language: English
Subjects: Constructivist grounded theory; Continuum of care; Coordination of care; Delivery of health care; Ghana; Low birth weight; Neonatal nursing; Newborn care
Subject (DDC): 362: Health and social services
618.92: Pediatrics
Abstract: Background: Low birth weight (LBW) is associated with short and long-term consequences including neonatal mortality and disability. Effective linkages in the continuum of care (CoC) for newborns at the health facility, community (primary care) and home care levels have a high tendency of minimizing adverse events associated with LBW. But it is unclear how these linkages work and what factors influence the CoC process in Ghana as literature is scarce on the views of health professionals and families of LBW infants regarding the CoC. Therefore, this study elicited the drivers influencing the CoC for LBW infants in Ghana and how linkages in the CoC could be strengthened to optimize quality of care. Methods: A constructivist grounded theory study design was used. Data was collected between September 2020 to February 2021. A total of 25 interviews were conducted with 11 family members of LBW infants born in a secondary referral hospital in Ghana, 9 healthcare professionals and 7 healthcare managers. Audio recordings were transcribed verbatim, analyzed using initial and focused coding. Constant comparative techniques, theoretical memos, and diagramming were employed until theoretical saturation was determined. Results: Emerging from the analysis was a theoretical model describing ten major themes along the care continuum for LBW infants, broadly categorized into health systems and family-systems drivers. In this paper, we focused on the former. Discharge, review, and referral systems were neither well-structured nor properly coordinated. Efficient dissemination and implementation of guidelines and supportive supervision contributed to higher staff motivation while insufficient investments and coordination of care activities limited training opportunities and human resource. A smooth transition between care levels is hampered by procedural, administrative, logistics, infrastructural and socio-economic barriers. Conclusion: A coordinated care process established on effective communication across different care levels, referral planning, staff supervision, decreased staff shuffling, routine in-service training, staff motivation and institutional commitment are necessary to achieve an effective care continuum for LBW infants and their families.
URI: https://digitalcollection.zhaw.ch/handle/11475/28903
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Nursing (IPF)
Appears in collections:Publikationen Gesundheit

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Schuler, C., Agbozo, F., Ntow, G. E., & Waldboth, V. (2023). Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana. BMC Pediatrics, 23(1), 501. https://doi.org/10.1186/s12887-023-04330-5
Schuler, C. et al. (2023) ‘Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana’, BMC Pediatrics, 23(1), p. 501. Available at: https://doi.org/10.1186/s12887-023-04330-5.
C. Schuler, F. Agbozo, G. E. Ntow, and V. Waldboth, “Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana,” BMC Pediatrics, vol. 23, no. 1, p. 501, Oct. 2023, doi: 10.1186/s12887-023-04330-5.
SCHULER, Christina, Faith AGBOZO, George Edward NTOW und Veronika WALDBOTH, 2023. Health-system drivers influencing the continuum of care linkages for low-birth-weight infants at the different care levels in Ghana. BMC Pediatrics. 5 Oktober 2023. Bd. 23, Nr. 1, S. 501. DOI 10.1186/s12887-023-04330-5
Schuler, Christina, Faith Agbozo, George Edward Ntow, and Veronika Waldboth. 2023. “Health-System Drivers Influencing the Continuum of Care Linkages for Low-Birth-Weight Infants at the Different Care Levels in Ghana.” BMC Pediatrics 23 (1): 501. https://doi.org/10.1186/s12887-023-04330-5.
Schuler, Christina, et al. “Health-System Drivers Influencing the Continuum of Care Linkages for Low-Birth-Weight Infants at the Different Care Levels in Ghana.” BMC Pediatrics, vol. 23, no. 1, Oct. 2023, p. 501, https://doi.org/10.1186/s12887-023-04330-5.


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