Background: Data on utilization of outpatient departments (OPD) within a country is one strategic approach to gain nationwide and regional insights into the frequency of and types of health facilities where patients seek healthcare. In particular, such data could be used to develop quality improvement interventions in sub-Saharan Africa where the burden of stroke is high but outcomes are relatively poor.
Purpose: To evaluate the characteristics of out-patient clinic visits by stroke survivors in Ghana by geo-ecological region (state) and by type of health facilities.
Methods: We conducted a retrospective analysis of prospectively collected data from 2019 to 2021 via the District Health Information System (DHIMS2) platform of the Ghana Health Service. Rates of stroke OPD encounters were expressed as number of visits by stroke survivors divided by number of OPD visits in a healthcare facility per 100,000 visits.
Results: Across, 9309 health facilities, there were 23,074 stroke OPD encounters in 2019, 19,485 in 2020 and 20,333 in 2021. Rates of stroke OPD visits were 109.2/100,000 visits population in 2019, 96.5/100,000 visits in 2020 and 99.7/100,000 visits in 2021. The highest rates of stroke OPD visits occurred in the middle-belt regions over the study period perhaps reflecting the distribution of the national stroke burden. Nearly 75% of all stroke OPD visits occurred at a primary level, 17% at secondary- level, and 8% at tertiary-level health facilities.
Conclusion: The middle geo-ecological belt has the highest rate of stroke OPD attendance in Ghana with nearly 3 out of 4 stroke patients seeking healthcare at a primary health care (PHC) facility. There is therefore a need to build human and infrastructural capacity at the lower cadres of healthcare delivery to optimally address stroke care delivery in these settings.
Keywords: Geo-ecological distribution; Health facilities; Out-patient; Stroke survivors.
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