Assessment Of Pre Referral Care And Referral Appropriateness Of Emergency Obstetric Care In Jimma Medical Center

Abstract

Background: Referrals between health care facilities is crucial in emergency obstetrics care to ensure appropriate level of care to women and newborns. The timely decision and appropriate pre referral care will significantly affect maternal and perinatal outcome. However, there was paucity of study on the maternal referral practices in Ethiopia and in Oromia region, in particular. The aim of this study was to assess the emergency obstetrics pre referral care and referral appropriateness of mothers referred to Jimma medical center, southwest, Ethiopia. Methodology: A cross sectional study was conducted including all mothers referred to Jimma medical center for obstetric emergency care during the study period. They were interviewed at labor ward and their chart was reviewed. the pre-referral care given and the process of patient transfer was assessed using a structured tool. A total of 340 women participated in this study. The data was collected by trained health professionals using structured questionnaires. The collected data was entered into Epi data version 4.6 and then it was exported to SPSS version 26 for statistical analysis. Descriptive statistics used to analyze mean and frequency. Result: A total of 340 mothers who were transferred to Jimma medical center for emergency obstetric care were involved during the study period. Among study participants, our result showed that the referral papers were not standard format for 21(6.2%) of clients and only about quarter (94, 27.6%) of the mothers were accompanied by health professionals. Majority of the clients (292, 85.9%) are transferred to Jimma medical center from referring health facilities without prior notification and only few of them have prior notification 48(14.1%). 154(45.3%) of clients were referred for further investigation and management. Lack of blood (66, 19.4%) and no/nonfunctional OR (62, 18.3%) were the second and third reason for referral. Pre referral treatment and referral paper was statistically associated with appropriate referral with CI: 0.341, 1.059 AOR of 0.601 and CI: 0.266, 0.727, AOR 0.439.