Experiences of healthcare providers and caregivers regarding health system bottlenecks affecting child healthcare service delivery in a rural district: Empirical qualitative study.
Felix Kwasi Nyande, Esmeralda Ricks, Margaret Williams and 1 others
PMID 38978331WHAT IT FOUND
Nurses and caregivers in rural Ghana described child wards overcrowded, beds and equipment lacking, medicines scarce, and hygiene poor.
These bottlenecks forced improvised care, reduced monitoring, and made families avoid or leave clinics.
Key findings
01Children were sometimes cared for on the floor because beds were full, and caregivers had no sleeping place.
02Missing monitors and supplies meant required monitoring was not done, and disposable items were reused.
03Persistent medicine shortages caused caregivers to be sent to buy drugs, avoid clinics, or self-medicate.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 26 participants from a rural district in Ghana, so the experiences may not apply to other settings. The study did not include community leaders, opinion leaders, or healthcare managers. It describes experiences and does not measure how often care was missed, how many children were harmed, or whether fixing supplies would improve outcomes. The interviewer was a doctoral nursing student, and nurse managers introduced participants, which may have shaped what participants said. Many interviews were conducted in Twi and translated into English, which can affect meaning.
Declared interests
The doctoral study was funded by the Nelson Mandela University Postgraduate Research Scholarship fund. The authors declared no conflicts of interest.
The easy way to misread this
Do not read these themes as proof that adding beds, equipment, or medicines will reduce child mortality. The study only describes what nurses and caregivers experienced, and it did not test an intervention or measure clinical outcomes.