Filiations 1 Department of Pharmacy, Noakhali Science and Technology University, Noakhali, Bangladesh two School of Pharmacy, Monash University Malaysia, Selangor, Malaysia three Unit for Medication Outcomes Investigation and Education (UMORE), Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia 4 Vector-borne Illnesses Research Group (VERDI), Faculty of Pharmacy, Universiti Teknologi PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21331531 MARA (UiTM), Puncak Alam, Malaysia Acknowledgements
^^Open AccessResearchCompetence of health workers in emergency obstetric care: an assessment employing clinical vignettes in Brong Ahafo region, GhanaTerhi Johanna Lohela,1,2 Robin Clark Nesbitt,2 Alexander Manu,three,four Linda Vesel,five,6 Eunice Okyere,7,eight Betty Kirkwood,three Sabine GabryschTo cite: Lohela TJ, Nesbitt RC, Manu A, et al. Competence of wellness workers in emergency obstetric care: an assessment applying clinical vignettes in Brong Ahafo region, Ghana. BMJ Open 2016;6:e010963. doi:ten.1136bmjopen-2015010963 Prepublication history for this paper is readily available on line. To view these files please go to the journal on-line (http:dx.doi.org10.1136 bmjopen-2015-010963). Received 23 December 2015 Revised 22 April 2016 Accepted 27 AprilABSTRACT Objectives: To assess overall health worker competence inemergency obstetric care working with clinical vignettes, to link competence to availability of infrastructure in facilities, and to typical annual delivery workload in facilities. Design and style: Cross-sectional Health Facility Assessment linked to population-based surveillance information. Setting: 7 districts in Brong Ahafo region, Ghana. Participants: Most knowledgeable delivery care providers in all 64 delivery facilities inside the 7 districts. Principal outcome measures: Wellness worker competence in clinical vignette actions by cadre of delivery care provider and by type of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Results: Vignette scores were moderate overall, and differed substantially by respondent cadre ranging from a median of 70 right amongst physicians, via 55 among midwives, to 25 among other cadres 
which include wellness assistants and wellness extension workers ( p0.001). Competence varied drastically by facility sort: hospital respondents, who had been mostly medical doctors and midwives, achieved highest scores (70 appropriate) and clinic respondents scored lowest (45 correct). There was a lack of affordable crucial drugs and gear to carry out vignette actions, and more generally, lack of competence to use readily available items in clinical circumstances. The typical annual workload was really unevenly distributed amongst facilities, ranging from 0 to 184 deliveries per skilled birth attendant, with greater workload linked with greater vignette scores. Conclusions: Lack of competence might limit clinical practice a lot more than lack of relevant drugs and gear. Cadres other than midwives and medical doctors may not have the ability to diagnose and handle delivery complications. Checking clinical competence by way of vignettes as well as checklist items could contribute to a far more complete approach to evaluate quality of care. Trial registration quantity: NCT00623337.Strengths and limitations of this studyWe made use of clinical vignettes to assess health worker competence in rural Ghana, picking two significant causes of maternal mortality that independently functioning delivery care specialists really should be capable to diagnose and handle. Even though not A-1155463 manufacturer nationally or longitudinally re.