Description of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India

BMC Health Services Research
Archana B PatelPatricia L Hibberd

Abstract

In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India. Pregnant women from 20 rural Primary Health Centers near Nagpur, Maharashtra were followed throughout pregnancy and to day 42 post-partum. Inter- institutional referral was defined as transfer of a woman from a first or second level facility where she was admitted for labor and delivery to facility providing higher level of care, after admission to the day of delivery. Maternal mortality, stillbirth, early and late neonatal mortality were compared in mothers who were and were not referred. Factors associated with inter-institutional referral were analyzed using multivariable models with generalized estimating equations, adjusted for clustering at the level of the Primary Health ...Continue Reading

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References

Apr 4, 2006·Lancet·Khalid S KhanPaul Fa Van Look
Jun 29, 2012·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Shivaprasad S GoudarRobert L Goldenberg
Feb 11, 2015·BMJ : British Medical Journal·Cheryl Travasso

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Citations

Jul 30, 2019·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Margo S HarrisonA Metin Gülmezoglu
Apr 18, 2018·Journal of Obstetrics and Gynaecology of India·Anahita R ChauhanMadhva Prasad
Jul 30, 2021·Journal of Family Medicine and Primary Care·Asha Elizabeth MathewJasmine Helan Prasad

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