Improving Quality of Care Through In-Service Training at Akatsi South Municipal Hospital, Volta Region, Ghana An Evaluation Study

Abstract

Background: Healthcare systems in developing countries face challenges in maintaining quality care, with Ghana presenting a mixed picture of progress and healthcare challenges. Despite global initiatives to strengthen human resources, evidence suggests that increasing skilled health workers correlates with improved healthcare outcomes. In-service training programs have emerged as a critical intervention to enhance healthcare professionals' knowledge and skills, particularly in resource-limited settings like Akatsi South Municipal Hospital. General Objective: To evaluate the effectiveness of in-service training programs in enhancing the quality of healthcare service delivery at Akatsi South Municipal Hospital. Methods: An embedded mixed-methods design was employed, combining a retrospective review of hospital records and key informant interviews of 31 healthcare professionals. Data from these key informants (healthcare professionals) were collected using a closed-ended questionnaire administered through Kobo Collect. Data from document review were manually obtained from hospital records as evidence of in-service training programs and key maternal and child health indicators. STATA 18 was used for analysis. Frequencies and percentages were reported. Fisher's exact test was done to identify associated variables. Variables with p<0.05 were considered to be significant. For the document analyses, each document was reviewed in relation to the study objectives, and key insights were extracted, summarised, and organised thematically around training coverage, health service delivery trends, and performance indicators. Findings: The study identified several training programs, including Helping Babies Breathe (83.9% participation), Obstetric Triage and Emergency Care (87.1%), and Quality Improvement refresher programs (48.4%). Training methods were mainly practical demonstrations (74.2%). Key quality indicators improved after training: birth asphyxia rates fell from 6.8% to 2.0%, maternal and neonatal deaths reduced from one in 2023 to none in 2024, and outpatient attendance increased by over 40%. Respondents reported improved confidence in neonatal resuscitation and obstetric triage. However, time constraint was identified as a challenge. Conclusions: In-service training significantly enhanced healthcare workers’ skills and contributed to improvements in maternal and newborn health outcomes at Akatsi South Municipal Hospital. The findings highlight the value of structured, practical, and continuous professional development. Institutional support, adequate resourcing, and integration of best practices are essential to sustaining the gains achieved through in-service training.