Assessing the public health impact of training ob/gyns in Ghana

This project assessed the national public health effect of the ob/gyn Ghana Postgraduate Training Program (GPTP) based on interviews with program graduates. The GPTP was established in 1989 to reduce maternal mortality and retain graduates by training ob/gyn specialists in Ghana. 98% of graduates practice in Ghana. 78 were interviewed for this study. Interviews were semi-structured, in English, and audiorecorded, focusing on four categories: clinical, teaching, leadership, and research experiences. Transcripts were entered into Microsoft Access for statistical and qualitative analysis. Graduates work in 8 of the 10 Ghanaian regions, actively engaging in clinical, teaching, leadership, and research work. Over 25% hold clinical leadership positions including department heads and family planning directors. Many consult for outside agencies including NGOs, governmental policy-makers, Engender Health, and the World Health Organization. Graduates teach doctors, nurses, and/or midwives at their clinical setting. Approximately 50% practice in teaching hospitals, formally mentoring students and residents. Many engage in community education through media and church presentations. Over 15% were the first ob/gyns at their facilities. Their hospitals intercept cases formerly destined for larger cities, providing immediate care and reducing teaching hospitals' patient load. Additionally, the GPTP graduates have published over 100 peer-reviewed papers. Interviewees excelled in all four areas assessed (leadership, teaching, clinical work, and research). The GPTP has successfully retained graduates and positively impacts the country's health. This research informs and influences Ghanaian and international policy on maternal mortality reduction. The GPTP demonstrates successful sustainability, suggesting that it is a useful model for other countries.