Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries.


Filippi, V; Richard, F; Lange, I; Ouattara, F; (2009) Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries. Best practice & research Clinical obstetrics & gynaecology, 23 (3). pp. 389-400. ISSN 1521-6934 DOI: https://doi.org/10.1016/j.bpobgyn.2008.12.006

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Abstract

Near-miss cases often arrive in critical condition in referral hospitals in developing countries. Understanding the reasons why women arrive at these hospitals in a moribund state is crucial to the reduction of the incidence and case fatality of severe obstetric complications. This paper discusses how near-miss audits can empower the hospital teams to document and help reduce barriers to obstetric care in the most useful way and makes practical suggestions on interviews, analytical framework, ethical issues and staff motivation. Review of the evidence shows that case reviews and confidential enquiries appear particularly suitable to the understanding of delays. Criterion-based audits can also achieve this by establishing criteria for referral. However, hospital staff have limited intervention tools at their disposal to address barriers to emergency care at the community level. It is therefore important to involve the district management team and representatives of the community in auditing the health care seeking and treatment of women with near-miss complications.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 19250874
Web of Science ID: 266539200011
URI: http://researchonline.lshtm.ac.uk/id/eprint/5734

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