ArticlePloS one2013
Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 83 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
83 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Evaluations of effective coverage of maternal and child health services: A systematic review.Health policy and planning · 2022Pooled it
- Essential components of postnatal care - a systematic literature review and development of signal functions to guide monitoring and evaluation.BMC pregnancy and childbirth · 2022Pooled it
- A rapid systematic review and evidence synthesis of effective coverage measures and cascades for childbirth, newborn and child health in low- and middle-income countries.Journal of global health · 2022Pooled it
- Pooled it
- Cross-National Systematic Review of Neonatal Mortality and Postnatal Newborn Care: Special Focus on Pakistan.International journal of environmental research and public health · 2017Pooled it
- Linking household and facility data for better coverage measures in reproductive, maternal, newborn, and child health care: systematic review.Journal of global health · 2016Pooled it
- Did a quality improvement intervention improve quality of maternal health care? Implementation evaluation from a cluster-randomized controlled study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2020Trial
- Trial
- The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria.BMC pregnancy and childbirth · 2019Trial
- Effect of a maternal and newborn health system quality improvement project on the use of facilities for childbirth: a cluster-randomised study in rural Tanzania.Tropical medicine & international health : TM & IH · 2019Trial
- The influence of distance and quality of care on place of delivery in rural Ghana.Scientific reports · 2016Trial
- Assessing the quality of care in low- and middle-income countries: a rapid review of the landscape of assessment tools.BMJ global health · 2026Review
- Benchmarking newborn care quality in Ghana: Evidence from structured observations of clinical practice against WHO quality standards.PloS one · 2026Observational
- How effective coverage has been used to measure quality in maternal and child health services in sub-Saharan Africa: a scoping review.BMJ public health · 2026Article
- Exploring barriers and facilitators of providing maternal healthcare in Africa: systematic review protocol.Systematic reviews · 2025Article
- Effective coverage of skilled birth attendance in Ethiopia: a population-based cross-sectional study.BMC pregnancy and childbirth · 2025Article
- Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review.BMC health services research · 2024Article
- Article
- Quality of hospital labour and delivery care: A multilevel analysis in Southern Nations and Nationalities People's Region of Ethiopia.PloS one · 2024Article
- Health facilities preparedness to deliver maternal and newborn health care in Kilifi and Kisii Counties, Kenya.BMC health services research · 2023Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.
methodsWe conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC), emergency newborn care (EmNC) and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.
findingsDelivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.
conclusionOur comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards reducing maternal and newborn mortality.
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