The Health Facilities Regulatory Agency (HeFRA) has imposed a fine of GH₵105,000.00 on two healthcare facilities at South Odorkor in Accra, for employing the services of a quack midwife.
While the New Generation Medical Centre was slapped with the heaviest fine of GH₵ 80,000.00, the Adams Family Specialist Clinic has to cough out GH₵ 25,000.00 (both equivalent to $9,051.72).
HeFRA said the number of deaths, cases of injury, and other incidents, the use of an unqualified staff—Francisca Quaye— to provide service in a licensed facility for nearly 30 years informed the decision to impose the heaviest fine ever in the agency’s history on the two facilities.
In May this year, the regulatory agency launched investigations into the activities of the two healthcare facilities, following The Fourth Estate’s investigations into the work of Francisca Quaye, alias ‘Matron Gaga’, an unlicensed midwife. She worked at the two medical centres. The Fourth Estate’s 18-month investigations discovered that the quack midwife, who is currently on the run, had practiced for more than 30 years.
The Fourth Estate found evidence of multiple medical mishaps, including the disturbing death of at least two newborn babies at the New Generation Medical Centre within 11 months. The records of the facility were sanitised to hide these deaths.
HeFRA’s Registrar, Dr Philip Bannor, told The Fourth Estate that “both of them [the two medical facilities] have paid the fine. The reason [they were fined] is that they should have checked her credentials before employing her.”
Dr Bannor said the fine imposed on the New Generation Medical Centre is the highest penalty ever slapped on a facility for flouting HeFRA’s regulations. He explained that management of the two facilities looked on while the quack midwife practiced, without any checks, with preventable deaths recorded at the New Generation Medical Centre.
HeFRA’s position affirmed Dr Ralph Obeng’s confession to The Fourth Estate that he could have handled the situation better.
“I agree with you. It was probably a little bit of naivety on my part…But the thing with her was she was a little boisterous when it came to things of that nature. Anytime there was a problem, I used to talk to her. It was supervision, I didn’t know there would be so many problems,” Dr Obeng told The Fourth Estate in October 2021.
“…Partly, I’ll take the blame because she has been under my tutelage for quite a while,” he added.
HeFRA said as part of measures to ensure compliance with the sanctions, the two facilities have been informed that there would be unannounced special monitoring visits.
These visits are meant to ensure that the two facilities do not employ the services of an unqualified staff.
During the investigations, the Medical Director of the Adam Family Specialist Clinic, Dr Nana Oduro Essuman, told The Fourth Estate that the quack midwife was employed as a midwife assistant, a position the Nursing and Midwifery Council (N&MC) says does not exist. However, further investigations by HeFRA showed that Francisca Quaye delivered two babies during her two-month stint at the clinic.
Unannounced inspections by HeFRA
The fine is part of a wave of reforms The Fourth Estate investigations have triggered.
Until The Fourth Estate’s exposé, HeFRA was required to announce schedules for its visits to health facilities for inspections.
However, Agyeman Badu, HeFRA’s Director of Compliance and Enforcement told The Fourth Estate that the two healthcare facilities had lost that privilege as the agency’s inspectors would visit the facilities for six months until it was satisfied with their level of compliance.
Similarly, he said HeFRA had decided to do intermittent unannounced visits to all registered healthcare facilities nationwide, as part of measures to curtail the ingenious ways some facilities hid their unscrupulous activities.
He observed that the gaping loopholes in HeFRA’s monitoring system had been reviewed and that mechanisms for monitoring health facilities in the country had been enhanced.
“Relative to this particular story, [The Fourth Estate’s Quack Midwife Series], we have decided that it shouldn’t always be the case that we are prompted. So, we have stepped up our monitoring activities across the regions such that even facilities that have been licensed also fall in line, to make sure that the conditions for which they are licensed are not varied, which will affect patient safety.”
He said HeFRA now has 200 monitoring officers nationwide for the job.
HeFRA announced investigations into the activities of the two health facilities following an investigative report by The Fourth Estate which showed the shocking trail of deaths and malpractices at the New Generation Medical Centre under Francisca Quaye’s watch.
Now on the run, she had practised without either training or license for more than 30 years. During this period, she was the instrument of numerous medical mishaps, with at least two children dying during delivery and another maimed at the New Generation Medical Centre within 11 months.
The New Generation Medical Centre, however, concealed the two deaths recorded at the facility, as it told the Greater Accra Regional Health Directorate that it did not record a single death, be it a mother or a child from 2016 to 2021.
The President of the Midwives Association of Ghana, Mary Ofosu, condemned Francisca Quaye’s unconventional and inconsistent actions, including inducing pregnant women and asking them to go home, while she worked at the New Generation Medical Centre. She said the practice was inconsistent with midwifery practice.
“A midwife cannot do induction on her own,” she said of Matron Gaga’s Cytotec procedure. “There must be a medical officer or specialist around. You should also have a theatre around because induction can fail. So, when you induce and it fails, we need to take the client to the theatre. So, before you do induction, you need to get all those things around.”
The Fourth Estate’s investigations revealed that Francisca Quaye had never been to any nursing or midwifery training school.
To be recognised as a midwife in Ghana, one has to complete an accredited nursing/midwifery training institution and pass a licensing exam conducted by the N&MC, renewable annually. Any exemption to this rule may only be granted by the board of the N&MC.
Francisca Quaye has neither a license nor an exemption. In fact, the closest she got to the ward was being a janitor at the now-defunct Susan Clinic, where she met Dr Obeng, who did little to stop her from the labour ward.
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