An Observational Analytical Study of Obstetric Referral Services
摘要
Referral is a dynamic process, in which a health worker at one level of the health system, having insufficient resources (drugs, equipment, skills) to manage a clinical condition, seeks the help of a better or differently resourced facility at the same or higher level to assist in. Referral system plays a vital role in management of diseases in any healthcare system. The study was undertaken to evaluate the obstetric referral system.
MethodsThis was a hospital-based prospective observational study. It included all obstetric referred women admitted in the hospital with more than 20 weeks gestational age or postpartum for further management. History was taken regarding details of referring centre and treatment given there, vehicle used, time taken to reach referral centre, attendant availability, etc. Data were then analysed.
Results220 referred women were included in the study. Most referrals were from Government CHC (52.27%) and District Hospital (44%).75.45 % women by Government ambulance. 90.90 % of the women reached the referral centre in less than 3 hours. All women referred from MCH centre and 76.29% from the Government District Hospitals were seen by gynaecologist before referral and in 83.18% cases, the health care attendants accompanied the woman.
ConclusionImproving referral services involves a multi-faceted approach addressing health care infrastructure, human resources, technology, community engagement and policy.