Cross-context qualitative synthesis of a mobile obstetric referral emergency system (MORES) in Ghana and Liberia

by Camilla Bjelland, Joseph Sieka, Veronica Millicent Dzomeku, HaEun Lee, Wahdae-Mai Harmon-Gray, Emmanuel K. Nakua, Jody R.

Lori Background To address the delayed provision of obstetric emergency care in Ghana and Liberia, our team previously implemented a mobile obstetric emergency referral system (MORES) connecting rural health facilities (RHFs) and district hospitals through a South-South-North triangular collaboration. This secondary qualitative data analysis aimed to synthesize the perceived barriers and benefits associated with the adoption of MORES in Ghana and Liberia.

To guide this cross-context synthesis, we utilized Rogers’ Diffusion of Innovation Theory. Methods The analysis included individual interviews conducted among 29 district hospital providers and 33 rural health facility (RHF) workers in Liberia.

In Ghana, 11 midwives at a district hospital participated in a focus group discussion. The codes were developed utilizing an inductive process.

Thematic analysis was utilized to compare adoption across countries through the Diffusion of Innovation Theory. Findings Four themes were identified from the healthcare workers in Ghana and Liberia: compatibility, relative advantage, resource barriers, and limited implementation.