Abstract ID: 47
Authors:
Gillian Bogee
Abdul-Jaleel Mumuni
Kofi Odei Asare-Ansah
Kankpeyeng Zinedeme Banbinbu Lawrence
Titigah B. Abraham
Hanyul Lee,
Myeongseon Kim
Jooyoung Kim
Eunju Cho
Juhwan Oh
Affiliations:
Bolgatanga Regional Hospital, Ghana Health Service, Upper East Region, Ghana; North East Gonja District Health Directorate, Ghana Health Service, Savannah Region, Ghana; Bongo District Hospital, Ghana Health Service, Upper East Region, Ghana; War Memorial Hospital, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Department of Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea; KOICA-CHPS+ Phase II, Caleb & Company, Seoul, Republic of Korea.
Abstract:Access to safe and timely surgical care remains a major challenge in low- and middle-income countries, including Ghana, where district hospitals often face shortages of skilled personnel, infrastructure, and essential supplies. In response, the Ghana Health Service, with support from KOICA, implemented Essential Surgical Care (ESC) training in selected district hospitals within the Upper East Region to build local capacity for emergency surgical interventions. This study evaluated the impact of ESC training on surgical service delivery using a quasi-experimental multi-group Interrupted Time Series Analysis (ITSA) design. Monthly routine health data from May 2022 to April 2025 were analyzed from four intervention hospitals (Bongo, Fumbisi, Talensi, and Zebila) and two control hospitals (Kasena-Nankana West and Builsa South). Key outcomes included the number of emergency surgeries, surgical referrals, and surgical site infections (SSI). A statistically significant post-intervention increase in emergency surgical volume was observed in Bongo District Hospital (β = 1.17; p = 0.019). However, no significant changes were detected in the other intervention hospitals or in the pooled analysis (β = 0.74; p = 0.414). The intervention had no significant effect on surgical referrals or SSIs across sites, though marginal SSI improvements were noted in Talensi (β = 0.063; p = 0.098). ESC training may enhance surgical service delivery where facility readiness is high. Broader systems support, including mentorship, infrastructure, and resource investments, is essential to ensure consistent and sustainable improvements across district hospitals.
Keywords: Health Systems and Universal Health Coverage (UHC), Essential Surgical Care, Interrupted Time Series, Surgical Access, Ghana, CHPS+, Health Systems
