Midwifery Workload and Its Effects on Quality Client Care: A Case Study in the Central Region of Ghana

Abstract

Introduction: The goal of the project was to analyze and explore the midwifery workload and its effects on clients’ quality care in some selected districts in Central Region. Methods: Quantitative cross-sectional and exploratory study designs were employed using 388 participants for the quantitative aspect while 12 participants for the qualitative. The target population was all midwives working in the four selected districts. Online structured questionnaire and in-depth interview were the main data collection tools for the study. Data were analysed with SPSS version 23.0. Descriptive and regression with Pearson Chi square and p-value were the main statistical tools for the data analysis. Results: The daily working hours for the midwives was 7 hours and 6 days per week. The workload for the midwives was higher than normal since the average patient-midwife ration for the district was 7.2:1 while bed-midwife ratio was 5:1. Quality of care was low since most of the indicators were below average (effectiveness of care =32.4%, safety of care =45.3%, efficient use of medical logistics =47.6% and timeliness of care =36.0%). However, maternal and infant mortality rates = 97.6% with average score of 54.8%.The qualitative findings supported the quantitative results. Conclusions: There was high midwifery workload in the districts as patient-midwife ratio was above the standard of 4:1 which affected quality care negatively. More midwives should be posted to the districts to augment the staff strength of midwives to improve health care at the district level of the Central Region.