Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana

Mamalelala, Tebogo T; Mokone, Ditebogo J; Obeng-Adu, Felix

doi:10.1016/j.afjem.2022.07.014

Cited by 6 publications

(6 citation statements)

References 27 publications

(28 reference statements)

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“…Though not as explicitly documented, this scenario may be indicative of the demonstrated larger problem and is likely true in other countries as well [17,47,50]. Research exploring this in other countries describes ineffective task sharing between doctors and midwives, and delays in family members authorizing providers to initiate emergency care measures.…”

Section: Discussionmentioning

confidence: 95%

“…Though little discussed, resistance to treating PPH in rural facilities has been noted in the literature [16] Although provision of initial stabilization of PPH is within the scope of most rural health facilities, typically these facilities have less resources and expertise than tertiary facilities, and thus may feel ill equipped to treat critical patients [17][18][19]. Facilities designated for normal birth may feel vindicated by global and national guidelines that often mention to treat or refer [20].…”

Section: Introductionmentioning

confidence: 99%

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Reducing maternal mortality through identifying unmet need for postpartum hemorrhage stabilization in rural emergency obstetric care facilities: Development and testing of a tool in Bangladesh

Mamun,

Shajahan,

Williams

et al. 2023

Preprint

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Background: Maternal mortality is stagnating globally, and postpartum hemorrhage (PPH) is the leading contributor. Time from onset of PPH to death is estimated at two hours, the fastest of all life-threatening obstetric complications. Resistance to treatment of critical obstetric emergencies in rural settings is ubiquitous and under-reported. Ensuring initial stabilization close to communities is central to improving maternal mortality rates. Systemic and unspoken refusal of care leads to hidden unmet need for treatment of PPH. Current global guidance for monitoring emergency obstetric care may be inadequate. Aim: The aim of this research was to develop a tool that measures unmet need for PPH stabilization in local health facilities. The newly developed tool was tested in rural sub-districts in Bangladesh. The results and their implications are discussed. Method: A proposed calculation was developed for determining the expected number of PPH cases in a given population based on its size, birth rates, community delivery rate, and estimates of PPH rates. Using the new tool, calculated estimates were applied to rural districts in Bangladesh against actual numbers of PPH cases managed in public district and sub-district hospitals. Births in private and NGO facilities were also accounted for. Findings: Substantial discrepancies were found between expected PPH arising in rural areas and PPH treated in rural facilities in those areas. The actual number of cases treated at local rural public facilities was 16% of what was expected. This is a notable finding that is missed by using global recommendations for monitoring EmONC signal functions. Conclusion: The proposed tool presents an opportunity for countries to examine the availability of facility response to obstetric emergencies, specifically PPH, in facilities reported to be providing basic emergency obstetric care. Establishing a simple method for the calculation of expected numbers of PPH will help countries to address hidden gaps. Further research is needed in other contexts to verify this tool and investigate if uncovering under performance of health facilities could be an opportunity for strengthening maternal and newborn health systems.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Reducing maternal mortality through identifying unmet need for postpartum hemorrhage stabilization in rural emergency obstetric care facilities: Development and testing of a tool in Bangladesh

Mamun,

Shajahan,

Williams

et al. 2023

Preprint

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“…Central Statistics Office of Botswana's health reports primary health care data in the aggregate, combining emergency care and outpatient non-emergency visits [20] . Trauma and abortion-related complications were the most typical reasons for referral to a tertiary hospital and a district hospital in Botswana [ 20 , 21 , 22 ]. Nonetheless, the country lacks a standardized method for reporting statistics in the health system [ 23 , 24 ].…”

Section: Healthcare Delivery System In Botswanamentioning

confidence: 99%

“…In Botswana, primary hospitals, district hospitals, and tertiary hospitals all have emergency rooms that are also known as accident and emergency (A&E) departments. In a typical Botswana emergency department, there are beds for patient assessment and observation, a designated triage area, and a resuscitation segment [36] These emergency departments function as both a point of admission for walk-in patients and a point of entry for patients transferred from lower-level facilities [ 19 , 22 ].…”

Section: Emergency Departments and Emergency Nursing Carementioning

confidence: 99%

Nurses and emergency nursing care in Botswana

Mamalelala

Dithole

Maripe-Perera

2023

African Journal of Emergency Medicine

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“…Nurses are the backbone of providing first aid at the level of basic health services. As a 24-hour service provider, nurses are required to be able to provide fast and appropriate health services for people who need them, including one of them is assisting in cardiac arrest events (Mamalelala, Dithole, & Maripe-Perera, 2023).…”

Section: Introductionmentioning

confidence: 99%

Determinants factors on Public Health Centre nurses' confidence in performing cardiopulmonary resuscitation

Sasmito,

Purnamasari,

Sumartini

et al. 2024

Internat.Jrnl.

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Background: Most cardiac arrests occur outside the hospital (out-of-hospital cardiac arrest/OHCA). Public Health Centre (PHC) nurses are one of the important components of the chain of survival. The confidence of PHC nurses in performing Cardiopulmonary resuscitation (CPR) is still questioned.Purpose: To analyze the factors determining the level of confidence of PHC nurses in performing CPR.Method: An observational analytical study with a cross-sectional approach involving 30 nurses from 2 PHCs in Banten Province, Indonesia taken using a total sampling technique.Results: A total of 30 participants participated in this study. The average age of participants was 36.4 years with an age range between 26-55 years. Most participants were male 17/56.7%, had a diploma education background of 21/70.0%, and had upgraded their BLS training 23/76.7%. On average, participants had worked for 6.5 years and managed 3.4 cases of cardiac arrest (CA) during their time as nurses. It was found that gender, educational background, and BLS training status were not associated with the nurse's level of confidence in performing CPR. While employment status has a significant relationship with confidence in performing. Age has a strong relationship with self-confidence with an r rank value of 0.447. Length of work also showed a relationship with self-confidence with an r-rank value of 0.503. Likewise, the number of CA cases ever managed has a relationship with self-confidence with an r rank of 0.419.Conclusion: Gender, educational background, and BLS training status were not associated with nurses' confidence levels in performing CPR. Employment status, age, length of work, and number of CA cases managed were associated with nurses' confidence in performing CPR.

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Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana

Cited by 6 publications

References 27 publications

Reducing maternal mortality through identifying unmet need for postpartum hemorrhage stabilization in rural emergency obstetric care facilities: Development and testing of a tool in Bangladesh

Reducing maternal mortality through identifying unmet need for postpartum hemorrhage stabilization in rural emergency obstetric care facilities: Development and testing of a tool in Bangladesh

Nurses and emergency nursing care in Botswana

Determinants factors on Public Health Centre nurses' confidence in performing cardiopulmonary resuscitation

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