Are maternal healthcare services accessible to vulnerable group? A study among women with disabilities in rural Nepal

Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora

doi:10.1371/journal.pone.0200370

“…Lack of medical supplies and essential utilities such as electricity and clean water could also result in poor care experiences as reported in South Sudan [88]. Training adequate numbers of obstetric healthcare providers and ensuring an equitable distribution can mitigate some of the challenges confronting quality maternal and newborn referrals [89][90]. Quality referral was interpreted differently by authors in the different studies.…”

Section: Discussionmentioning

confidence: 99%

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

Ameyaw

¹

,

Njue

²

,

Tran

³

et al. 2020

Preprint

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Background: Sub-Saharan African Low and Lower-Middle Income Countries (SSA LLMICs have the highest burden of maternal and neonatal morbidity and mortality in the world. Timely and appropriate obstetric referral to a suitable health facility is a sign of effective health system. This paper presents the findings of a systematic review that aimed to identify what referral practices are delivered according to accepted standards for pregnant women and newborns in SSA LLMICs by competent healthcare providers and in line with the need and wishes of women. Methods: Six electronic databases were systematically searched for primary data studies (2009-2018) in English reporting on maternal referral practices and their effectiveness. We conducted a content analysis guided by a framework for assessing the quality of maternal referral. The articles defined quality referral as: the timely identification of signal functions, established guidelines or standards, adequate documentation, staff accompaniment and prompt care by competent healthcare providers at the receiving facility. Results: Seventeen articles were included in the study. Most studies were quantitative (n=11). Two studies reported that women were dissatisfied due to delays in referral processes that affected their health. Most of the articles (10) reported that women were not accompanied to higher levels of healthcare, delays in referral processes, transportation challenges and poor referral documentation. Some healthcare providers administered essential drugs such as misoprostol prior to referral. Conclusions: Efforts to improve maternal health in LLMICs should aim to enhance maternal healthcare providers’ ability to identify conditions that demand referral. Low cost transport is needed to mitigate transportation barriers of referral. To ensure quality maternal referral, mechanisms should be instituted for health managers at the district level to monitor and evaluate referral documentation, quality and efficiency of maternal referrals on regular basis.

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“…Lack of medical supplies and essential utilities such as electricity and clean water could also result in poor care experiences as reported in South Sudan [85]. Training adequate numbers of obstetric healthcare providers and ensuring an equitable distribution can mitigate some of the challenges confronting quality maternal and newborn referrals [86][87].…”

Section: Discussionmentioning

confidence: 99%

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

Ameyaw

¹

,

Njue

²

,

Tran

³

et al. 2020

Preprint

1

0

View full text Add to dashboard Cite

Background: Sub-Saharan African Low and Lower-Middle Income Countries (SSA LLMICs have the highest burden of maternal and neonatal morbidity and mortality in the world. Timely and appropriate obstetric referral to a suitable health facility is a sign of effective health system. This paper presents the findings of a systematic review that aimed to identify what referral practices are delivered according to accepted standards for pregnant women and newborns in SSA LLMICs by competent healthcare providers and in line with the need and wishes of women. Methods: Six electronic databases were systematically searched for primary data studies (2009-2018) in English reporting on maternal referral practices and their effectiveness. We conducted a content analysis guided by a framework for assessing the quality of maternal referral. The articles defined quality referral as: the timely identification of signal functions, established guidelines or standards, adequate documentation, staff accompaniment and prompt care by competent healthcare providers at the receiving facility. Results: Seventeen articles were included in the study. Most studies were quantitative (n=11). Two studies reported that women were dissatisfied due to delays in referral processes that affected their health. Most of the articles (10) reported that women were not accompanied to higher levels of healthcare, delays in referral processes, transportation challenges and poor referral documentation. Some healthcare providers administered essential drugs such as misoprostol prior to referral. Conclusions: Efforts to improve maternal health in LLMICs should aim to enhance maternal healthcare providers’ ability to identify conditions that demand referral. Low cost transport is needed to mitigate transportation barriers of referral. To ensure quality maternal referral, mechanisms should be instituted for health managers at the district level to monitor and evaluate referral documentation, quality and efficiency of maternal referrals on regular basis.

show abstract

“…Lack of medical supplies and essential utilities such as electricity and clean water could also result in poor care experiences as reported in South Sudan [86]. Training adequate numbers of maternity care providers and ensuring an equitable distribution can mitigate the challenges confronting quality maternal and newborn referrals [87][88].…”

Section: Discussionmentioning

confidence: 99%

Quality and women’s satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: A systematic review 

Ameyaw

¹

,

Njue

²

,

Tran

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: sub-Saharan African Low and Lower-Middle Income Countries (sSA LLMICs) have the highest burden of maternal and perinatal morbidity and mortality in the world. Timely and appropriate maternal referral to a suitable health facility is an indicator of effective health systems. In this systematic review we aimed to identify which referral practices are delivered according to accepted standards for pregnant women and newborns in sSA LLMICs by competent healthcare providers in line with the needs of pregnant women.Methods: Six electronic databases were systematically searched for primary data studies (2009-2018) in English reporting on maternal referral practices and their effectiveness. We conducted a content analysis guided by a framework for assessing the quality of maternal referral. Quality referral was defined as: timely identification of signal functions, established guidelines or standards, adequate documentation, staff accompaniment and prompt care by competent healthcare providers in the receiving facility.Results: Seventeen articles were included in the study. Most studies were quantitative (n=11). Two studies reported that women were dissatisfied due to delays in referral processes that affected their health. Most articles (10) reported that women were not accompanied to higher levels of care, delays in referral processes, transport challenges and poor referral documentation. Some healthcare providers administered essential drugs such as misoprostol prior to referral.Conclusions: Efforts to improve maternal health in LLMICs should aim to enhance maternity care providers’ ability to identify conditions that demand referral. Low cost transport is needed to mitigate barriers of referral. To ensure quality maternal referral, district level health managers should be trained and equipped with the skills needed to monitor and evaluate referral documentation, including quality and efficiency of maternal referrals. Systematic review registration: PROSPERO registration CRD42018114261

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Are maternal healthcare services accessible to vulnerable group? A study among women with disabilities in rural Nepal

Cited by 44 publications

References 23 publications

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

Quality and women’s satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: A systematic review

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Are maternal healthcare services accessible to vulnerable group? A study among women with disabilities in rural Nepal

Cited by 44 publications

References 23 publications

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review

Quality and women’s satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: A systematic review&nbsp;

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Quality and women’s satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: A systematic review