{
  "abstract": "Purpose: The Christian Health Association of Ghana (CHAG) with technical assistance from a Non-Governmental Organisation, PharmAccess is implementing a quality improvement programme in selected health facilities using the SafeCare international standards and methodology. The programme is planned to be transferred to the network of CHAG health facilities to run sustainably after an initial two years. The current study examines challenges and opportunities in the implementation of the programme and based on lessons learnt, explore factors that will promote or constrain a sustainable transitioning to CHAG network.\n\nMethod: The study used a cross-sectional qualitative design (multiple case studies) and interviewed 93 individuals from 27 health facilities, 9 assessors, 12 heads of Church Health Directorates (CHD), 3 officers from CHAG and 2 from PharmAccess. A thematic analytical approach was used in analysing and reporting the findings.\n\nResults: Findings indicate that poor programme awareness among health facility leadership and staff as well as among CHD leadership adversely affected buy-in and commitment at the early stages of implementation, although this changed for the better later. Challenges included lack of motivated staff, inadequate finance, poor access to relevant information and the internet and lack of appropriate administrative and governance structures for implementation. Notwithstanding these challenges, SafeCare became popular and is seen as impactful by all stakeholders and therefore recommended to be continued with CHAG.\n\nConclusion: CHAG can take advantage of the willingness to adopt SafeCare, the positive attitude among stakeholders and the complementary findings of this study to develop a sound, inclusive and sustainable transition strategy for scaling.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana",
    "PharmAccess Foundation Ghana, P.O. Box CT 10245, East Cantonment, Accra, Ghana",
    "PharmAccess Foundation Amsterdam, Paasheuvelweg 25, Amsterdam, 1105 BP The Netherlands",
    "Christian Health Association of Ghana, P. O. Box AN 7316, Labone, Accra Ghana",
    "Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon,Accra, Ghana",
    "Ministry of Health, P. O. Box M 44, Sekou Toure Ave. North Ridge, Accra, Ghana"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
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        0
      ],
      "name": "Gordon Abekah-Nkrumah",
      "orcid": "0000-0001-8017-6521"
    },
    {
      "affs": [
        1
      ],
      "name": "Maxwell Antwi"
    },
    {
      "affs": [
        1
      ],
      "name": "Bonifacia Benefo Agyei"
    },
    {
      "affs": [
        2
      ],
      "name": "Tobias F. Rinke de Wit"
    },
    {
      "affs": [
        2
      ],
      "name": "Aafke E. de Graaff"
    },
    {
      "affs": [
        3
      ],
      "name": "James Duah"
    },
    {
      "affs": [
        0
      ],
      "name": "Grace Adjei Okai"
    },
    {
      "affs": [
        4
      ],
      "name": "Doris Ottie-Boakye"
    },
    {
      "affs": [
        5
      ],
      "name": "Odile Anukware Nkrumah"
    },
    {
      "affs": [
        1
      ],
      "name": "Gifty Sunkwa-Mills"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/crn61x9smhhfw.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-28933-6",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13741699/",
  "id": "crn61x9smhhfw",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://doi.org/10.1186/s12889-026-28933-6",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "3600|Health Policy Implementation Science"
    ]
  ],
  "openalex": "W7202074526",
  "pdf_url": null,
  "pmcid": "PMC13741699",
  "pmid": "42989215",
  "published": "2026-08-10",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/crn61x9smhhfw.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:22:42Z",
      "native_id": "PMC13741699",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12889-026-28933-6"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1471-2458",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Assessment of SafeCare healthcare quality improvement program for sustainable scaling in Ghana",
  "title_text": "Assessment of SafeCare healthcare quality improvement program for sustainable scaling in Ghana",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:22:42Z",
  "url": "https://research.draconitic.com/paper/crn61x9smhhfw",
  "venue": "BMC Public Health",
  "versions": []
}