Are bicycle ambulances and community transport plans effective in strengthening obstetric referral systems in Southern Mulawi?

Lungu, Kingsley; Kamfose, V.; Chilwa, B.; Hussein, Julia

doi:10.1016/s0020-7292(00)85200-5

Cited by 19 publications

(43 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The two RCTs that targeted the community reported improved health facility utilisation in intervention arms (OR 3.56 95% CI 2.68–4.72) [16] and (OR 3.01 95% CI 2.08–4.36) [12]. Of the remaining three studies that showed lower rates of delivery in health facilities in the intervention group, the reported effect of bicycle ambulances was most striking [23]. During the study, more women from villages without bicycle ambulances delivered in health facilities—70% in control villages compared to 49% of women in villages with bicycles.…”

Section: Resultsmentioning

confidence: 96%

The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings: A Systematic Review

et al. 2012

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 96%

The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings: A Systematic Review

et al. 2012

View full text Add to dashboard Cite

show abstract

“…However, they found that cultural beliefs deterred pregnant women from using bicycle ambulances (Lungu et al . ). Thus, some consideration needs to be given to cultural acceptance before an innovative transport intervention is introduced.…”

Section: Discussionmentioning

confidence: 97%

An ambulance referral network improves access to emergency obstetric and neonatal care in a district of rural Burundi with high maternal mortality

Tayler‐Smith

Zachariah

Manzi

et al. 2013

Tropical Med Int Health

View full text Add to dashboard Cite

Abstractobjectives In 2006, M edecins sans Fronti eres (MSF) established an emergency obstetric and neonatal care (EmONC) referral facility linked to an ambulance referral system for the transfer of women with obstetric complications from peripheral maternity units in Kabezi district, rural Burundi. This study aimed to (i) describe the communication and ambulance service together with the cost; (ii) examine the association between referral times and maternal and early neonatal deaths; and (iii) assess the impact of the referral service on coverage of complicated obstetric cases and caesarean sections.methods Data were collected for the period January to December 2011, using ambulance log books, patient registers and logistics records.results In 2011, there were 1478 ambulance call-outs. The median referral time (time from maternity calling for an ambulance to the time the patient arrived at the MSF referral facility) was 78 min (interquartile range, 52-130 min). The total annual cost of the referral system (comprising 1.6 ambulances linked with nine maternity units) was € 85 586 (€ 61/obstetric case transferred or € 0.43/capita/year). Referral times exceeding 3 h were associated with a significantly higher risk of early neonatal deaths (OR, 1.9; 95% CI, 1.1-3.2). MSF coverage of complicated obstetric cases and caesarean sections was estimated to be 80% and 92%, respectively.conclusion This study demonstrates that it is possible to implement an effective communication and transport system to ensure access to EmONC and also highlights some of the important operational factors to consider, particularly in relation to minimising referral delays.

show abstract

“…When a problem occurs during labor, transportation to the nearest health care facility becomes risky, and the woman often needs to travel farther to a hospital. Motor and bicycle ambulances projects have been initiated but traditional beliefs sometimes prevent women in labor from being transported, especially in a bicycle ambulance [10]. Once, rather than seeking transportation for a young primigravida, her mother-in-law beat her up because she was not able to deliver vaginally-and the obstructed labor produced a large VVF plus an RVF.…”

Section: Discussionmentioning

confidence: 99%

Urogenital and recto‐vaginal fistulas in southern Malawi: A report on 407 patients

Rijken¹,

Chilopora²

2007

Intl J Gynecology & Obste

View full text Add to dashboard Cite

This study from Southern Malawi reports on 407 patients with 408 vaginal fistulas (1 patient had 2 successive fistulas). There were 29 patients (7.6%) with a combined urogenital and recto-vaginal fistula. Obstructed labor was the cause of 379 fistulas and the remaining 29 were not of obstetric origin. Although the actual incidence of vaginal fistulas is unknown, the incidence is probably much lower in Malawi than in other African countries. The rate of closure at first repair was 94.1% for urogenital fistulas but it reached 98.5% overall. For recto-vaginal fistulas, closure at first repair was 78.8% but the overall rate of successful closure was 87.9%. Stress incontinence was seen in 16.2% of the patients immediately after repair and in 6.2% after 6 months. The latter rate is certainly too low, however, as 26 of 63 patients were lost to follow-up. A national fistula task force has been set up in Malawi.

show abstract

Are bicycle ambulances and community transport plans effective in strengthening obstetric referral systems in Southern Mulawi?

Cited by 19 publications

References 0 publications

The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings: A Systematic Review

The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings: A Systematic Review

An ambulance referral network improves access to emergency obstetric and neonatal care in a district of rural Burundi with high maternal mortality

Urogenital and recto‐vaginal fistulas in southern Malawi: A report on 407 patients

Contact Info

Product

Resources

About