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Sanford World Clinics: Providing Essential Primary Care in Ghana and Beyond

Sep 05, 2013 08:31AM ● By MED Editor

The best way to provide health care to a child is to improve a mother’s health.


Nowhere is that statement more accurate than in the sub-Saharan country of Ghana, says Ann Mays, Sanford Health’s Director of Clinical Services for the Sanford World Clinics initiative. 

In 2007, Sanford Health launched the Sanford World Clinics initiative to develop pediatric primary care clinics in the U.S. and around the world in areas lacking such services. Sanford determined that in many emerging countries, the most effective way to improve the health of children is to treat the entire family. 

So Sanford expanded its mission to include the potential for hundreds of community clinics in emerging markets to provide primary care for children and adults. 

“You can’t separate the child from the family,” says Mays. “If a mother dies, a child is considered an orphan. They don’t go to school. They don’t get fed. It fits our mission to treat the whole family.”

In January 2012, Sanford also began providing a permanent health care infrastructure in the African country of Ghana.  Currently, Sanford has four operational clinics, with plans to complete an initial network of 10 clinics in the next two to three years. 


A unique culture

Ghana has a great need for medical services. Nationwide, there are only two physicians and nine nurses or midwives for every 100,000 patients in the country.

“People can wait in lines for hours,” says Mays. “There’s a lot of traditional medicine, and spiritual healing.  People who don’t have access to care may go to someone who is not properly trained.”

In Ghana, malaria is the number one cause of death, with 4.1 million cases treated annually.  Women of childbearing age are at great risk for a variety of health problems. The rate of maternal deaths during pregnancy is high, as many as 350 women out of every 100,000 pregnancies. And one out of 12 children will die before their fifth birthday.

Ghana is considered an emerging country, but the social and economic culture can be challenging. The country is working to revamp its National Health Insurance Scheme and much of the records are primitive. Only 71 percent of births are registered and there is no integrated data collection system.


Improving the system

Sanford has made investments to clinic infrastructure, as well as clinical and operational enhancements. A great deal of effort is focused on improving patient workflow to ensure providers can see patients as efficiently as possible. 

At Sanford’s facilities, patients do not encounter the long waits as they would at other facilities in Ghana. At one Sanford facility, three to four doctors see an average of 1,300 patients per week.

One of Sanford’s most important enhancements with its Ghana clinics is implementing one of the first Electronic Medical Record (EMR) platforms in that country. The EMR ensures patients’ records and history are immediately accessible.

“Now no matter which clinic they go to, we have a patient chart,” says Mays.

Sanford’s World Clinics initiative also concentrates on empowering and educating medical professionals to do their job. Sanford provides training to help make up for a lack of standardization of medical education in the area.

World Clinics officials provide standardized financial and operational processes, and needed supplies and equipment. They also teach infection prevention and control, medication administration, assessment skills and standard treatment guidelines to protect patients who come through the doors.

“We work to institute a culture of safety,” says Mays. “We’ve been fortunate to build an administrative team to lead our operations and clinical services locally. They want to give back to their country and improve the care provided there.”

A long-term goal is moving beyond treating the urgent cases – malaria, skin infections, respiratory tract issues, wounds and diarrhea – to do real preventive work, she says.

A new initiative will be piloted at one of the clinics later this year to offer pre-natal and reproductive health services for women. By offering education and standardized medical care prior to giving birth, the clinics can start encouraging more preventive care and reach out to more women and families.

“We are doing great things in Ghana, working the way we need to, taking small steps,” says Mays. “We’ve laid foundations and we’re teaching. You drop one pebble in the water and see the ripples it creates.”