Examining the Impact of Integrated Obstetric Simulation Training on the Quality of Antenatal Care in Northern Ghana.

Abstract

Objectives: This study aims to assess if an integrated simulation-based training on respectful maternity care (RMC) and management of obstetric and neonatal emergencies could improve the quality of antenatal care (ANC).

Methods: The data are from two cross-sectional surveys administered in the East Mamprusi District of Northern Ghana in 2017 to evaluate the impact of integrated simulation-based training for healthcare providers. Surveys were administered to two groups of women aged 15-49 who delivered in a health facility before (baseline; n = 266) and 6 months after (end-line; n = 320) the intervention began. We assessed the quality of antenatal care pre- and post-training across two dimensions: service provision and experience of care. Analyses included linear and logistic regression.

Results: Women in the end-line group reported higher quality of antenatal care than those in the baseline group. The average ANC experience of care score increased by 10 points at the end-line (Coeff = 10.3, 95%CI: 9.0,11.6), whereas the mean ANC service provision score increased by three points (Coeff = 2.6, 95% CI: 2.2, 3.1). End-line participants were more likely to have an ultrasound (OR: 24.1, 95%CI: 11.5, 50.3). Parity, tribe, education, employment, partner occupation, six or more antenatal visits, ANC facility, and provider type were also associated with ANC quality.

Conclusions: Integrated simulation-based training for health providers has the potential to improve the quality of ANC. Incorporating such training into continuing professional development courses will aid global efforts to increase the quality of care throughout the maternity continuum of care.