Ascertaining the commitment of management in maintaining an effective quality assurance system: a case study of Ejisu-Juaben District, Ashanti Region, Ghana

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The Ministry of Health (MOH) has been recently engaged in the establishment of QA teams, In Eastern, Upper West, Central, Volta and fairly recently Ashanti Regions. The Ejisu district is one of the eighteen districts in Ashanti Region, where a QA team has been institutionalised in the Juaben hospital since May 2000. However, the District Directorate suggests an ineffective QA System in the hospital. The commitment, of management appears not forthcoming. Establishing QA teams is no guarantee that functions will be performed. Management has a role to play in the establishment and maintenance of any QA system: through the provision of clearly defined principles, training, timely and adequate allocation of resources, provision of tools for supervision and monitoring. In their work Adogboba et al (March, 2000) suggest a further study into other areas of QA operation in respect of management practices. Hence the decision to embark on this project to help define the central role of management in maintaining these QA teams structures on a continuous basis. Hopefully policies could be formulated in this direction to help ensure the discharge of management’s duty with respect to QA operation. The project was basically a descriptive cross-sectional study and a purposive evaluative study of the QA team in the Juaben Hospital. Twenty- nine (all but one) management members in all five sub-districts were given self-administered questionnaire and client evaluation study at Juaben hospital. A focus group was then held which brought together eight people (three patients, three members of staff and two management members) of the Juaben hospital. From the study it was realised that there is no well-communicated principle for the operation of QA. It was also realised that there is no demonstrable commitment QA operation by management by way of resources. It was also realised that training for low level management in QA has not been done to a large extent, Supervisory and monitoring tools for QA structures have not been provided and finally even though a large majority of patients are satisfied with services being rendered at the Juaben hospital, they have not been provided with an interface through which their grievances could be brought to the notice of management. It is hoped that this will help management to know their responsibility in ensuring the sustenance of the QA system on a continuous basis; even though it must be admitted that the QA team in Juaben hospital is only about 6 months old and probably not due for evaluation at this stage.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfilment of the requirements for the award of Master of Science in Health Services Planning and Management, 2001