Oromia Regional Health Bureau, Addis Ababa, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia.
Midwifery. 2019 Dec;79:102528. doi: 10.1016/j.midw.2019.08.010. Epub 2019 Aug 13.
In developing countries including Ethiopia, maternal mortality ratio remains unacceptably high. During pregnancy and childbirth, a woman may acquire one or more of obstetric complications including hemorrhage, sepsis, hypertension and obstructed labor. Early diagnosed and referral of women who experienced obstetric complications to a specialty center can save the life of women and babies. However, several factors might affect the referral procedures of these women. Therefore, this study was aimed at assessing the facilitators and barriers of obstetric referral in selected public health facilities of Addis Ababa city administration, Ethiopia.
A qualitative study design was employed to obtain the narratives of 12 healthcare workers and three recently referred mothers. The study included a regional health bureau, a lead hospital and a health center. Thematic analysis was employed to present to present the findings of the study and open code software was used to code and generate the themes.
This study revealed several barriers and some facilitators of obstetric referral. Early identification of complications, exercising teamwork, availability of referral protocol, availability of ambulance and effective communication system were the major reported factors which enhanced obstetric referral. Several themes including poor perception of clients, poor supportive supervision, lack of staff motivation and shortage of beds and medical equipment, lack of competence among the staffs and shortage of ambulance at health center were emerged as barriers of obstetric referral.
This study revealed several barriers of obstetric referral in the Addis Ababa city administration although a number of facilitators of obstetric referral exist. All of the reported barriers are related to the existing health system that need a collective action of all the actors to eliminate the barriers while enhancing the facilitators of obstetric referral.
在包括埃塞俄比亚在内的发展中国家，孕产妇死亡率仍然高得令人无法接受。在妊娠和分娩期间，妇女可能会患上一种或多种产科并发症，包括出血、败血症、高血压和产道梗阻。早期诊断和将经历产科并发症的妇女转介到专业中心，可以挽救妇女和婴儿的生命。然而，一些因素可能会影响这些妇女的转介程序。因此，本研究旨在评估埃塞俄比亚亚的斯亚贝巴市行政当局选定的公共卫生机构中产科转介的促进因素和障碍。
采用定性研究设计，获取了 12 名医护人员和 3 名最近转介的母亲的叙述。该研究包括一个地区卫生局、一家龙头医院和一个卫生中心。采用主题分析来呈现研究结果，并使用开放代码软件对主题进行编码和生成。
本研究揭示了产科转介的一些障碍和一些促进因素。早期识别并发症、团队合作、转诊协议的可用性、救护车的可用性和有效的沟通系统是增强产科转介的主要报告因素。几个主题包括客户的不良认知、支持性监督不力、缺乏员工激励和床位及医疗设备短缺、员工能力不足以及卫生中心缺乏救护车，这些都是产科转介的障碍。
本研究揭示了亚的斯亚贝巴市行政当局存在一些产科转介障碍，尽管存在一些产科转介的促进因素。所有报告的障碍都与现有的卫生系统有关，需要所有利益相关者共同采取行动，消除障碍，同时加强产科转介的促进因素。
