ETD Collection

Permanent URI for this collectionhttps://wiredspace.wits.ac.za/handle/10539/104


Please note: Digitised content is made available at the best possible quality range, taking into consideration file size and the condition of the original item. These restrictions may sometimes affect the quality of the final published item. For queries regarding content of ETD collection please contact IR specialists by email : IR specialists or Tel : 011 717 4652 / 1954

Follow the link below for important information about Electronic Theses and Dissertations (ETD)

Library Guide about ETD

Browse

Filters

20122

Settings

Subject: search.filters.subject.Referral and Consultation

Search Results

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Referral pattern for maternity patients in the Nkhensani district hospital in Giyani sub-district
    (2012) Mboweni, Agrey Ernest
    Background: Nkhensani Hospital is a level 1 district hospital which provides comprehensive and integrated health care for the Giyani sub–district population, which is estimated to be 270 000. The major services provided are casualty, medicine, paediatrics, maternity and surgery. The hospital is experiencing challenges in the maternity ward which is admitting more patients than the 47 allocated beds. Monthly, an average of 400 women are admitted for delivery from clinics. The causes are suspected to be due to a number of different factors like shortage of staff at the clinics, poor referral system, poor services at clinics and health centres, poor facilities, and pregnant woman not attending antenatal care and bypassing lower levels of care. Aim: To describe the pattern and appropriateness of referrals in patients attending the maternity ward at the Nkhensani Hospital. Methodology: A retrospective study was used to review and asses the patient records for the study (January to December 2009). Information was obtained from the Hospital Information System and secondary data from patients records will be used to assess the referral pattern in Nkhensani Hospital’s maternity ward. Results: The data showed that the patients admitted had a mean age of 26 years, with a range from 15 to 45 years. Patients were admitted for various reasons, which when categorised were found to have 57% of inappropriate referrals. Similarly 68% of referrals were found to have low risk pregnancies. About 85% of the deliveries were normal vaginal deliveries. Of the patients who attended the facility, 57% were referred from clinics, 19% from community health centres, 1% from general practitioners and 23% as self referrals. The source of referral was not found to be v associated with appropriate reasons for delivery, risk category, length of stay or mode of delivery. Conclusion: The research showed that the referral pattern in the maternity ward from clinics and health centres as well as self referrals indicated that policies were not being adhered to, which led to an over utilisation of the maternity ward in Nkhensani Hospital under Giyani sub-district
  • No Thumbnail Available
    Item
    Assessment of referrals to a district hospital maternity unit in South Africa
    (2012) Mashishi, Mathiba Maria
    Introduction: A functioning and effective referral system is essential to improve maternal care services. There are guidelines that identify the types of maternity care that should be provided at the different levels of care, and define referral pathways and appropriate management of patients at each level of care. Compliance with referral and patient management guidelines is important to ensure appropriate utilization of different levels of maternal care services, and to prevent maternal and peri-natal mortality. This study assesses the referral of pregnant women to Dilokong district hospital maternity unit for delivery, to evaluate the proportion of referred women who delivered at the appropriate level of care. Methods: This was a descriptive cross sectional study involving retrospective review of hospital records for mothers who delivered in the maternity unit of Dilokong hospital during January to December 2008. Data were collected from 400 records using a data extraction sheet. Data were collected on demographic variables, clinical and obstetric history, distance to Dilokong hospital, and type of referral (self-referred or health professional referred). Analysis determined the appropriateness of referrals for delivery at the Dilokong hospital level of care. Results: Most women delivering at the hospital maternity unit were self-referred and inappropriate for the level of care. A total of 333 women (85%) were self-referred and 57% were inappropriate for delivery at the hospital level of care. Most women used Dilokong hospital as their first contact with the health care system even though many lived closer to a clinic or CHC. Among self-referrals, only 121 (37%) were appropriate for delivery at the hospital level of care. The majority (74%) of health-professional referred women were appropriately referred for hospital delivery. The results also show that the majority (67%) and (53%) of self-referrals and inappropriate referrals respectively were brought to the hospital by ambulance. Conclusion: This study shows that referral pathways are not functioning in line with referral guidelines for maternal care. The bypass of primary care facilities by most women in the study results in inappropriate utilization and potentially overloading of the hospital maternity unit. Non-compliance with referral guidelines defies the efficient functioning of health services. This could be addressed by developing mechanisms to improve and continuously monitor compliance; and doing further studies to determine the contributory factors, particularly for self-referrals.