Criteria-based audit to improve a district referral system in Malawi: A pilot study

Kongnyuy, Eugene J, Mlava, G. and Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2008) 'Criteria-based audit to improve a district referral system in Malawi: A pilot study'. BMC Health Services Research, Vol 8, e190.

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Abstract

Background: To study the feasibility of using criteria-based audit to improve a district referral system.
Methods: A criteria-based audit was used to assess the Salima District referral system in Malawi. A retrospective review of 60 obstetric emergencies referred from 12 health centres was conducted and compared with prior established standards for optimal referral of emergencies. Recommendations were made and implemented. Three months later, a re-audit was conducted (62 cases).
Results: There were significant improvements in 4 out of 7 standards: adequate resuscitation before referral (33.3% vs 88.7%; p = 0.001); delay of less than 2 hours from the time the ambulance is called to when the ambulance brought the patient to the hospital (42.8% vs 88.3%; p = 0.014); clinician attends to patient within 30 minutes of arrival to hospital (30.8% vs 92.6%; p = 0.001) and feedback given to the referring health centres (1.7% vs 91.9%; p < 0.001). The rest of the three standards showed a high level of attainment (> 95%) in both the initial audit and the re-audit: referred patients accompanied by a referral form; ambulances are available at all times and the district hospital is informed through short-wave radio by the health centre when a patient is referred.
Conclusion: Criteria-based audit can improve the ability of a district referral system to handle obstetric emergencies in countries with limited resources.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Health Administration and Organization > WA 525 General works WQ Obstetrics > WQ 100 General works WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
Digital Object Identifer (DOI):	https://doi.org/10.1186/1472-6963-8-190
Depositing User:	Users 19 not found.
Date Deposited:	13 Aug 2010 10:24
Last Modified:	17 Jul 2020 10:58
URI:	https://archive.lstmed.ac.uk/id/eprint/831

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