Faculty Bibliography

Background: Many district hospitals and medical centers in Ghana are limited with regard to the number of employed medical staff, hospital resources, and services available. Our team went to Kumawu Polyclinic to learn about the detailed operations of the hospital, resources, and to determine the challenges faced by the facility. A needs assessment was developed that can be used as a model for how to briefly and efficiently evaluate a district facility in Sub Saharan Africa. Methods: A team consisting of an emergency physician working at a tertiary referral hospital in Ghana and medical students from the United States developed a needs assessment and conducted a visit to Kumawu Polyclinic (Sekyere Afram Plains District, Ashanti Region, Ghana) over three consecutive days in July 2015. The team surveyed the facility, observed rounds with the medical staff, and conducted informal interviews with the polyclinic director and staff. Findings: Kumawu Polyclinic is a district health facility with 23 inpatient beds, split between three wards. There is only one medical officer (physician) at the hospital, along with one physician's assistant and a physician assistant in training. 25 nurses work at the hospital but only 8 are formally trained. The most common patient presentations are fever in children under five, pregnancy and delivery, and complications of noncommunicable diseases such as stroke and hypertensive crisis. The clinic faces several challenges, one being an unreliable supply of essential consumables from the Ghana Health Service. The polyclinic also has limited capability to run laboratory tests and has to send patients 45 minutes away to a larger facility for any imaging. Electric supply is intermittent and requires the use of a backup generator during periods of electrical failure. Interpretation: Our team recommended establishing a triage system for patient intake to increase the efficiency of the clinic. In addition, the needs assessment addressed the clinic's limited range of drugs it can prescribe, moving forward on a 25-bed extension, and the challenges of intermittent electricity. This method of assessing the needs of a district facility can be employed at other polyclinics in Ghana and in developing countries in Africa