A study on factors contributing to obstetric referrals from mpulungu urban clinic to mbala hospital,zambia.
Date
2013-04-15
Authors
Banda, Mackson.
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Abstract
The purpose of the study was to determine factors contributing to obstetric referrals from Mpulungu Urban Clinic to Mbala Hospital, so that measures could be taken to correct the situation.
Literature reviewed included global, regional and national literature. From the literature reviewed, it was discovered that most of the reasons given for obstetrical complications and maternal death were similar.
A descriptive cross sectional retrospective study design was used in conducting the study of factors contributing to obstetrical referrals from Mpulungu Urban to Mbala District Hospital.
The questionnaires were administered to all eleven (11) nurses/midwives who were conveniently selected. The checklist to record data from all 289 referred women with obstetric complications from 2002 to 2005 first quarter was used. Data analysis was done manually. The raw data from the study were collected and edited for completeness, uniformity and accuracy. The data was coded while those from open-ended questions were transcribed using content analysis. The coded data were entered on the Data Master Sheet.
The data were summarized and presented in the of frequency tables, cross tabulations, percentages, pie charts and graph to facilitate easy understanding of the factors contributing to obstetrical referral from Mpulungu Urban clinic to Mbala District Hospital.
The study findings revealed contributing factors to increased obstetrical referrals.
The major factor was inadequate knowledge of nurses in management women in labour. There were ineffective use of a partograph and it was not always available.
The other factor, that came out were erratic supply of the surgical supplies and none existence of labour ward protocols including the referral criterion. Non-existence of the labour ward protocols meant that the nurses were not properly guided on when to make referrals. The study also revealed critical shortage of nurses/midwives.
The study also revealed that each pregnancy was at risk regardless of the age of the woman and parity. Therefore, each pregnancy should be given the attention it deserves. It also revealed that late attendance of women to labour ward was another contributing factor.
Finally, the study revealed the common obstetrical cases that were referred.
Several recommendations have been made to MOH, GNC, DHMT, Health Centre and the
community.
The major recommendation made is that there is need for general nursing and midwifery to be merged so that the problem of shortage of midwives is dealt with. In the curriculum there is also need to incorporate a standard or use the WHO partogram design, which has pre-printed alert and action lines for Nursing Training Schools.
The GNC should inspect for the presence and effective use of the partograph in schools and health facilities.
A network with other organisations involved in educating the community on maternal and Child Health needs to be established, including the recipients of the services.
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Keywords
obstetrics --complications --northern province --zambia. , emergency medical services --obstetrics --mpulungu. , emergency medical services --obstetrics --mbala. , mothers --mortality --prevention --northern province --zambia.