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Ghanaian Nurses Train in U.S. to Improve Childbirth Conditions

Ben Cole, for HealthLeaders Media, June 9, 2009

Each year, hundreds of women die in Ghana while giving birth—with most of the deaths caused by complications such as acute hemorrhage, sepsis, pre-eclampsia, obstructed labor, and non-hemorrhagic anemia. While most of these diseases are considered preventable and treatable in the United States, a lack of specialized training make these conditions dangerous.

Last week, three nurses from Ridge Hospital, based in Accra, Ghana, trained at Forsyth Medical Center's Sara Lee Center for Women's Health in Winston-Salem, NC, to learn new ways to treat high risk, pregnant mothers. The Ridge hospital representatives shadowed nurses at the Sara Lee to observe the process from admittance to discharge to learn how to manage obstetrical patients and watch how the staff performs patient assessments, as well as collects and organizes patient data.

"The goal is to help reduce the mother mortality rates and infant mortality rates in Ghana," says Dinah Asante-Mensah, deputy matron for nursing administration at Ridge Hospital. "Mothers shouldn't lose their lives during childbirth, neither should children."

The initiative with Forsyth Medical Center, an affiliate of the Novant Health System, is part of an ongoing exchange with Ghana established in November 2004 by Kybele, Inc., a non profit organization that seeks to improve childbirth conditions worldwide through similar partnerships.

Kybele, Inc. has established a five-year partnership with the Ghana Health Service, and Forsyth Medical Center staff has also visited Ghana as part of the exchange.

"We've been working in Ridge Hospital since January of 2007— that's when the formal relationship began with the Ghana Health Service," says Medge Owen, MD, an obstetric anesthesiologist with Wake Forest University School of Medicine who practices at the Sara Lee Center for Women's Health. "At this point in time it's critical we have the nursing leadership involved at a very high level of this program because nothing can happen in a hospital without good nursing care."

Joining Asante-Mensah on the visit to Sara Lee last week were Rebecca Fofo Larkai, head of the labor ward at Ridge Hospital, and Winifred Gladys Nyarko, head of the obstetrical and gynecology ward.

The three will take the best practices they learned to help try to reach Kybele, Inc.'s goal to reduce by half the number of maternal and neonatal deaths in Ghana by 2011. According to statistics from the UNICEF, maternal mortality in Ghana is 540 deaths per 100,000 live births.

Kybele is also hosting Ghanaian physicians and Ghana Health Service personnel at Wake Forest University, Duke University, and the University of Chapel Hill.

"I think it's the exchange back and forth that is really important, and it's going to allow the program to grow," Owen says. "Even within the first year we've seen a tremendous amount of success and the Ghana Health Service is taking serious note of this program."

Asante-Mensah, agrees, saying that by making site visits to the U.S. hospitals is very important to improve conditions in Ghana, because "seeing is believing" and it is important to view the birthing practices firsthand.

"When we come here and they tell us about how they manage their cases successfully," Asante-Mensah says. "When we come here we are able to ask questions about why things are being done certain ways, and also when they come over there they see why we do things our way. We learn from each other, and you do understand each other better when you go."

The key to this program is sustainability, Owen says: having a plan, monitoring progress periodically, and ensuring the team in Ghana implements and sustains the improvements so that when the program ends the advances that have been made will continue on and set an example for the rest of the country.

Owen says that type of international exchange of information is very important, allowing participants to build a greater social fabric worldwide.

"We all should be concerned about healthcare, not only in our own backyard but also what's going on really on a global scale," Owen says. "I think we learn things from each other, and we create equality and partnerships. It's a greater awareness of other cultures, other workplace conditions."


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Ben Cole is an associate online editor with HealthLeaders Media. He can be reached at bcole@healthleadersmedia.com.

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