Avoka, Cephas K., McArthur, Eve and Banke-Thomas, Aduragbemi ORCID: 0000-0002-4449-0131
(2022)
Interventions to improve obstetric emergency referral decision making, communication and feedback between health facilities in sub-Saharan Africa: a systematic review.
Tropical Medicine and International Health, 27 (5).
pp. 494-509.
ISSN 1360-2276
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Text (Tropical Med Int Health - 2022 - Avoka - Interventions to improve obstetric emergency referral decision making)
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Abstract
Objective: The objective of the study was to review the evidence on interventions to improve obstetric emergency referral decision making, communication and feedback between health facilities in sub-Saharan Africa (SSA). Methods: A systematic search of PubMed, Embase, Cochrane Register and CINAHL Plus was conducted to identify studies on obstetric emergency referral in SSA. Studies were included based on pre-defined eligibility criteria. Details of reported referral interventions were extracted and categorised. The Joanna Biggs Institute Critical Appraisal checklists were used for quality assessment of included studies. A formal narrative synthesis approach was used to summarise findings guided by the WHO's referral system flow. Results: A total of 14 studies were included, with seven deemed high quality. Overall, 7 studies reported referral decision-making interventions including training programmes for health facility and community health workers, use of a triage checklist and focused obstetric ultrasound, which resulted in improved knowledge and practice of recognising danger signs for referral. 9 studies reported on referral communication using mobile phones and referral letters/notes, resulting in increased communication between facilities despite telecommunication network failures. Referral decision making and communication interventions achieved a perceived reduction in maternal mortality. 2 studies focused on referral feedback, which improved collaboration between health facilities. Conclusion: There is limited evidence on how well referral interventions work in sub-Saharan Africa, and limited consensus regarding the framework underpinning the expected change. This review has led to the proposition of a logic model that can serve as the base for future evaluations which robustly expose the (in)efficiency of referral interventions.
Item Type: | Article |
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Official URL: | https://onlinelibrary.wiley.com/journal/13653156 |
Additional Information: | © 2022 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd. |
Divisions: | LSE Health |
Subjects: | R Medicine > RA Public aspects of medicine |
Date Deposited: | 26 Apr 2022 12:42 |
Last Modified: | 10 Aug 2024 02:45 |
URI: | http://eprints.lse.ac.uk/id/eprint/114959 |
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