HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Delays in emergency obstetric referrals in Addis Ababa hospitals in Ethiopia: a facility-based, cross-sectional study.

AbstractOBJECTIVE:
To assess where the delays occur in the referral chain of most maternal health outcomes in Addis Ababa, Ethiopia, based on the three-delay model.
DESIGN:
The study was a facility-based, cross-sectional study.
SETTING:
Two public and tertiary hospitals in Addis Ababa.
PARTICIPANTS:
All pregnant women who were referred only for labour and delivery services after 28 weeks of gestation between December 2018 and February 2019 in Zewditu and Gandhi Memorial Hospitals.
PRIMARY AND SECONDARY OUTCOME MEASURES:
The primary outcome was the type of delays, from the three-delay model, which met operationally defined time. The secondary outcome was maternal health outcomes based on the three-delay model.
RESULTS:
A total of 403 pregnant women referred for delivery to the study hospitals were included in the study. Three-fourths (301, 74.7%) of the referred pregnant women experienced the third delay (delay in receiving appropriate care); 211 (52.4%) experienced the first delay (delay in making a decision to seek care). Overall 366 (90.8%) pregnant women had experienced at least one of the three delays and 71 (17.6%) experienced all three delays. Twenty-nine (7.2%) referred women had severe maternal outcomes. The leading causes/diagnoses of severe maternal outcomes were blood transfusion (17, 58.6%), followed by postpartum haemorrhage (15, 52%) and eclampsia (9, 31%). In addition, women who experienced severe maternal outcomes were 2.9 times more likely to have experienced at least one of the three delays.
CONCLUSION AND RECOMMENDATION:
This study highlights the persistence of delays at all levels, and especially the third delay and its contribution to severe maternal outcomes. We recommend strengthening the health referral systems and addressing specific health system bottlenecks during labour and birth in order to ensure no mother is endangered. We also recommend conducting a qualitative method of study (focus group discussion and indepth interview) and observing tertiary hospitals' set-up and readiness to manage obstetric emergencies.
AuthorsEndalkachew Mekonnen Assefa, Yemane Berhane
JournalBMJ open (BMJ Open) Vol. 10 Issue 6 Pg. e033771 (06 23 2020) ISSN: 2044-6055 [Electronic] England
PMID32580981 (Publication Type: Journal Article)
Copyright© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Topics
  • Adult
  • Cross-Sectional Studies
  • Emergencies
  • Ethiopia (epidemiology)
  • Female
  • Health Services Accessibility
  • Humans
  • Obstetric Labor Complications (epidemiology, therapy)
  • Pregnancy
  • Pregnancy Outcome
  • Referral and Consultation (statistics & numerical data)
  • Time-to-Treatment

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: