Referral Processes and Services for Expectant Mothers and Newborns at the Shai-Osudoku District Hospital

Abstract

Effective and improved maternal and new born health is a critical concern to all governments the world over and much particularly to those in low to middle income countries like Ghana. This led the global community to adopt the United Nations Millennium Development Goals 4 and 5 in order to improve the wellbeing and health of mothers and newborns. By 2015, the Millennium Development Goals (MDG) 4 calls for a reduction by 2/3 of the 1990 under-five mortality rate; and MDG 5 calls for a reduction by 3/4 of the maternal mortality ratio. Crucial to improved maternal and newborn care is the referral services for these groups of people. This is because access to care is determined to a greater extent on an effective referral system. This call for strengthening the referral process and services for expectant mothers and new borns.Thus the study intends to describe the referral processes and services for expectant mothers and newborns at the Shai-Osudoku district hospital. The study is a descriptive cross-sectional study involving health service providers and health administrators. It was conducted at the Shai-Osudoku district hospital and Ridge hospital in Accra where most referrals for expectant mothers and newborns are sent to from the Shai-Osuduku district hospital. It used interviews and questionnaires. Referral records for expectant mothers and newborns were reviewed.SPSS was used to analyse quantitative data. Interviews were recorded, transcribed and subsequently analysed using NVIVO software. The results of the study shows that service providers do not use referral protocols and guidelines in referring expectant mothers and newborns. For instance although 125(81.7%) of the records reviewed were regarded as Emergencies and therefore required adequate preparations at receiving facilities, contacts were not made to facilities prior to referrals of 101( 66.1%) of referred expectant mothers and newborns. It also showed that private and public transport 79(61.5%) are the major means of transporting referred expectant mothers and newborns to facilities. It concludes by indicating that the major consideration for choice of hospital is the availability of beds and distance to referral facilities. There is also the absence of handy protocols and guidelines at both the referring and receiving facilities for providers to refer to. The study recommends the use of existing referral documents and protocol, the need for service providers to accompany referred expectant mothers and newborns. It further advocate for the need for referring facilities to call referral centres prior to referring.