Critical comparative analysis of data sources toward understanding referral during pregnancy and childbirth: three perspectives from Nigeria.
Critical comparative analysis of data sources toward understanding referral during pregnancy and childbirth: three perspectives from Nigeria.
复制标题
DOI：
10.1186/s12913-021-06945-9
复制
发表时间：
2021-09-06
影响因子：
2.8
通讯作者：
Benova L
中科院分区：
文献类型：
--
作者：
Radovich E;Banke-Thomas A;Campbell OMR;Ezeanochie M;Gwacham-Anisiobi U;Ande ABA;Benova L
产妇和围产期死亡的最高风险发生在分娩期间和分娩后不久，如果有效的转诊系统使妇女在发生产科并发症时能够获得适当的保健服务，这一风险是可以预防的。在卫生设施分娩的人数不断增加，包括在尼日利亚等高死亡率环境中，需要在整个卫生系统进行正式协调，以确保妇女和新生儿在正确的时间得到正确的护理。本研究描述和批判性地评估转诊及其组成部分可以使用三个不同的数据来源从尼日利亚捕获的程度，检查数据质量，有效性和有用性的问题，以改善和监测产科护理系统。这项研究包括三个数据来源的分娩护理转介在尼日利亚：一个全国代表性的家庭调查，病人记录从多个设施在一个国家，病人记录从顶点转介设施在一个城市。我们对这三个来源的转诊状态和组成部分进行了描述性分析。我们还迭代地开发了一个视觉概念框架来指导我们的关键比较分析。我们发现，被转介的妇女比例存在很大差异，这反映了每个数据源中转介的不同因素和时间。在这三个数据来源中，16%至34%的转诊来自政府医院，在所有三个数据来源中都观察到横向转诊（同一级别的来源和目的地设施）。我们发现，转诊的关键组成部分的覆盖范围存在很大差距，而且在基于设施的来源中没有定期捕获这些信息的数据差距。我们的分析说明了不同的角度从国家到设施一级在捕获的程度和组成部分的产科转诊。通过对多个数据源进行三角测量，我们揭示了每种方法在建立更完整的产科转诊情况方面的优势和差距。我们认为我们的视觉框架有助于进一步的研究工作，以确保捕获所有转诊途径，以便更好地监测和改善妇女和新生儿的转诊系统。在线版本包含补充材料，可通过10.1186/s12913-021-06945-9获得。
The highest risk of maternal and perinatal deaths occurs during and shortly after childbirth and is preventable if functional referral systems enable women to reach appropriate health services when obstetric complications occur. Rising numbers of deliveries in health facilities, including in high mortality settings like Nigeria, require formalised coordination across the health system to ensure that women and newborns get to the right level of care, at the right time. This study describes and critically assesses the extent to which referral and its components can be captured using three different data sources from Nigeria, examining issues of data quality, validity, and usefulness for improving and monitoring obstetric care systems. The study included three data sources on referral for childbirth care in Nigeria: a nationally representative household survey, patient records from multiple facilities in a state, and patient records from the apex referral facility in a city. We conducted descriptive analyses of the extent to which referral status and components were captured across the three sources. We also iteratively developed a visual conceptual framework to guide our critical comparative analysis. We found large differences in the proportion of women referred, and this reflected the different denominators and timings of the referral in each data source. Between 16 and 34% of referrals in the three sources originated in government hospitals, and lateral referrals (origin and destination facility of the same level) were observed in all three data sources. We found large gaps in the coverage of key components of referral as well as data gaps where this information was not routinely captured in facility-based sources. Our analyses illustrated different perspectives from the national- to facility-level in the capture of the extent and components of obstetric referral. By triangulating across multiple data sources, we revealed the strengths and gaps within each approach in building a more complete picture of obstetric referral. We see our visual framework as assisting further research efforts to ensure all referral pathways are captured in order to better monitor and improve referral systems for women and newborns. The online version contains supplementary material available at 10.1186/s12913-021-06945-9.
登录
查看更多内容
影响因子：
3.2
作者：
Montagu, Dominic;Sudhinaraset, May;Donnay, France
通讯作者：
Donnay, France
DOI：
10.1016/j.bpobgyn.2016.05.006
发表时间：
2016-10-01
影响因子：
5.5
作者：
Blencowe, Hannah;Calvert, Clara;Campbell, Oona M. R.
通讯作者：
Campbell, Oona M. R.
影响因子：
9.7
作者：
Gage, Anna D.;Carnes, Fei;Kruk, Margaret E.
通讯作者：
Kruk, Margaret E.
影响因子：
3.4
作者：
Bailey, Patricia E.;Awoonor-Williams, John Koku;Singh, Kavita
通讯作者：
Singh, Kavita
影响因子：
168.9
作者：
Campbell, Oona M. R.;Graham, Wendy J.
通讯作者：
Graham, Wendy J.