INFLUENCE OF ACCESS DETERMINANTS ON SELF-REFERRALS AMONG PREGNANT WOMEN SEEKING DELIVERY SERVICE IN COAST GENERAL REFERRAL AND TEACHING HOSPITAL MOMBASA, KENYA
DOI:
https://doi.org/10.47604/gjhs.1249Keywords:
Access Determinants, Self-Referrals, Pregnant Women, Delivery ServiceAbstract
Purpose: The purpose of this study was to establish influence of access determinants on self-referrals among pregnant women seeking delivery service in Coast General Referral and Teaching Hospital (CGTRH).
Methodology: The study adopted a descriptive cross-sectional research. The study target population was all pregnant women seeking delivery services in coast general teaching and referral hospital at the maternity unit. Therefore, 6,420 formed the study population as it is from this sampling frame that a sample of mothers was obtained. A sample of 376 pregnant women was obtained. Systematic random sampling was used to select the pregnant women to be included in the sample. Data was collected using a structured questionnaire. The data collected were cleaned and coded, quantified and analyzed quantitatively. Quantitative data were analyzed using IBM SPSS where descriptive and inferential statistics were used to capture the data in order to understand the pattern and nature of relationships. Univariate analysis was done using descriptive statistics (frequencies and percentages,) in order to summarize the data, and the results were presented using charts, graph and tables.
Results: The findings revealed a significant relationship between the operating hours of CGTRH and self-referrals to the facility. The results indicated that pregnant women who indicated the 24 hours operating nature of CGTRH as their reason for seeking services at the facility were 2 times more likely to make self-referrals compared to those who disagreed that they sought services at the facility because the facility is open 24 hours in a day. A multivariable logistic regression analysis at a significance level of 0.05 further indicated that the operating hours of CGTRH had a significant influence on self-referrals pregnant women seeking delivery services at the facility.
Unique contribution to theory, practice and policy: The study recommended that The Mombasa county department of health should find ways of ensuring that primary health facilities in the county are open for 24 hours in a day to attract more pregnant women seeking delivery services at the facilities and thus minimize the number of pregnant women seeking delivery services directly from the Coast General Teaching and Referral Hospital.
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References
Abdi, W.O., Salgedo, W.B, Nebeb, G.T. (2015). Magnitude and Determinants of Self-referral of Patients at a General Hospital in Ethiopia. Science Journal of Clinical Medicine.
Abeno, T.A. (2014). The Determinants of Health Care Seeking and by Passing of Health Care Facilities in Kenya (Doctoral Dissertation). University of Nairobi.
Akande, T.M. (2004): Referral System in Nigeria: A Study of Tertiary Health Facility. Annuals of African Medicine.
Arab, K., Czuzoj-Shulman, N., Spence, A. & Abenhaim, H.A. (2016). Obstetrical Outcomes of Patients with HIV in Pregnancy: A Population Based Cohort. Obstetrics and Gynaecology.
Abrahim O, Linnander E, Mohammed H, Fetene N, Bradley E (2015):A Patient-Centered Understanding of the Referral System in Ethiopian Primary Health CareUnit.PloSONE.2015 Journal.
Abodunrin, O., Akande, T., & Osagbemi, G. (2010). Awareness and Perception toward Referral in Health Care: A Study of Adult Residents in Ilorin, Nigeria. Annals of African Medicine.
Becker J, Dell A, Jenkins L, Sayed R (2012.) Reasons Why Patients with Primary Health Care Problems Access a Secondary Hospital Emergency Centre. SAMJ: South African Medical Journal., PubMed.
Bayu, H., Adefris, M., Amano, A. & Abuhay, M. 2015. Pregnant Women's Preference and Factors Associated with Institutional Delivery Service Utilization in Debra Markos Town, North West Ethiopia: A Community Based Follow up Study. BMC.
Dlakavu, W. 2012. Self-referral of Women in Labour at Chris Hani Baragwanath Hospital after the Introduction of a Triage MMed, Pretoria, South Africa.
Cervantes, K., R. Salgado, M. Choi and H.D. Kalter, 2003. Rapid assessment of referral care systems: A guide forprogram managers. Proceedings of the Published by the Basic Support for Institutionalizing Child Survival Project, Arlington, Virginia.
Daudi O, Naboth A, Lawrence M, Leonard L(2008). Referral Pattern of Patients Received at The National Referral Hospital: Challenges in Low Income Countries. East Africa Journal of Public Health.
Edosa Tesfaye Geta1, Yibeltal Siraneh Belete, Dr. Elias Ali (2019) Determinants of Self-referral among
Dattaray, C., Mandal, D., Shankar, u Bhattacharya,P. & Mandal, S. 2013. Obstetric patients requiring high-dependency unit admission in a tertiary referral centre .International Journal of Critical Illness & Injury Science Outpatients at Referral Hospitals in East Woll,Western Ethiopia.
Duong, Binns, & Lee (2004), Utilization of Delivery Services at the Primary Health Care Level in Rural Vietnam, NGO Networks for Health, Hanoi, Vietnam.
Goh, A., Browning Carmo, K., Morris, J., Berry, A., Wall, M. & Abdel-Latif,M. (2015). Outcomes of High-Risk Obstetric Transfers in New South Wales and the Australian Capital Territory: The High-Risk Obstetric Transfer Study. Australian & New Zealand Journal of Obstetrics & Gynaecology.
GOK/MOH. (2016). Kenya Health sector referral implementation guidelines (2014)1st edition.
Hussein J, Kanguru L, Astin M, Munjanja S (2012). The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings:A Systematic Review. PLoS Med.
Ishandree Pillay , Ozayr Haroon Mahomed,(2019) Prevalence and Determinants of Self Referrals to a District-Regional Hospital in KwaZulu Natal, South Africa: A Cross-Sectional Study Pan African Medical Journal.
Kenya Ministry of Health. (2014) Kenya Health Sector Referral Implementation Guidelines. Nairobi, Kenya: Division of Emergency and Disaster RiskManagement, Ministry of Health; Kenya.
Kahabuka C, Kvåle G, Karen MM, Sven GH. (2011) Why Caretakers Bypass Primary Health Care Facilities For Child Care. Tanzania.
Kanyora, J. N. (2012). Factors Contributing to Patients Bypassing the 2nd and 3rdLevels of Primary Health Care Facilities in Kirinyaga District, Kenya.
Nath B, Kumari R, Tanu N. (2008).Utilization of the Health Care Delivery System in a District of North India. East African Journal of Public Health.
Magoro, S.M., (2015). FactorsContributing to Self-Referrals of Antenatal Women for Delivery at Dilokong Hospital, Greater Tubatse Local Municipality. PhD Thesis. University of limpopo
Majoko, F., Nystrom, L., Munjanja S.P. & Lindmark g. (2005). Effectiveness of Referral System for Antenatal and Intra-Partum Problems in Gutu District, Zimbabwe. Journal of Obstetrics & Gynaecology
Moodley, J., Pattinson, R.C., Fawcus, S., Schoon, M.G., Moran, n. &Shweni, P.M. (2014). TheConfidential Enquiry into Maternal Deaths in South Africa: A Case Study. Bjog: An International Journal of Obstetrics & Gynaecology
Murray SF, Pearson S. (2006) Maternity Referral Systems in Developing Countries: Current Knowledge and Future Research Needs. Social Science Medicine.
Mutihir, J.T. & Nyiputen, Y.A. (2007). The Unbooked Patient: A Lingering Obstetric pathology in Jos, Nigeria. Journal of Obstetrics and Gynaecology.
Mthethwa, R.O., (2006). The Factors Determining the Underutilization of Maternity Obstetric Units within the Sedibeng district (Doctoral dissertation). Available:https://scholar-googleco
Mashishi, (2012). Assessment of Referrals to a District Hospital. Available:http://wiredspace.wits.ac.za/bitstream/handle/10539/13656/Mashishi_RE24)
Moodley, J., Pattinson, R. Maseresha, Nebiyu., Kifle, Woldemichael. & Lamessa, Dube. (2016). Knowledge of Obstetric Danger Signs and Associated Factors among Pregnant Women in Erer district, Somali Region, Ethiopia. BMC Women's Health.
Masango-Makgobela AT, Govender I, Ndimande JV(2013). Reasons Patients Leave Their Nearest Healthcare Service to Attend Karen Park Clinic, Pretoria North: Original Research. African Journal of Primary Health Care and Family Medicine.
Mahinda, F. W. (2013). Determinants of Self Directed Referral amongst Patients Seeking Health Services at Kenyatta National Hospital, Nairobi, Kenya.
Pacagnella, R. C., Cecatti, J. G., Osis, M. J., & Souza, J. P. (2012). The Role of Delays in Severe Maternal Morbidity and Mortality: Expanding the Conceptual framework. Reproductive Health Matters.
Ntleko, T.L.(2010) Determining the Factors Related To Patients in the Umuziwa Bantu Sub-District of KwaZulu-Natal Bypassing Primary Health Care Facilities in 2010 and Accessing The District Hospital As Their Point of First Contact. Student Dissertation in Medicine, University of KwaZulu-Natal.
Pembe, A.B. (2010). Quality Assessment and Monitoring of Maternal Referrals in Rural Tanzania, Dissertation (Doctor of Philosophy), Faculty of Medicine,Uppsala University, Sweden.
Raj, S.S., Manthri, S. & Sahoo, P.K. (2015). Emergency Referral Transport for Maternal Complication: Lessons from the Community Based Maternal Death Audits in Unnao district, Uttar Pradesh, India. International Journal of Health Policy and Management.
Rwashana, A. S., Nakubulwa, S., Nakakeeto-Kijjambu, M., & Adam, T. (2014). Advancing the Application of Systems Thinking in Health: Understanding the Dynamics of Neonatal Mortality in Uganda. Health Research Policy and Systems.
Sines, D,Apple,F& Frost. M (2005), Community Health Care Nursing, United King dom,backwell publishers.
Rasoulynejad's. (2007). patients review for self-referral to specialist, Iranian journal public health.
Thaddeus, S., & Maine, D. (1994). Too Far to Walk: Maternal Mortality in Context. Social Science & Medicine.
Teresita A.(2014). The Determinants of Health Care Seeking and Bypassing of Health Care Facilities in Kenya.
WHO. Management of Health Facilities: Referral Systems, Who.Int (n.d.). https://www.who.in
WHO (2008) primary Health care (now more than ever)
WHO (2011), Care in normal Birth: a practical guide maternal and new born Health safe motherhood unit, Family and reproductive Health WHO ,GENEVA.
WHO, (2015) Henery J .Focus on Health Care Disparities Key Facts. Kaiser Family Foundation.
Wolkite O, Waju B, GebeyehuT. (2015). Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia. Science Journal of Clinical Medicine.
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Copyright (c) 2021 Elizabeth Muthoki Kivuva , Dr. Kezia Njoroge, Dr. Wanja Tenambergen
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