| Summary: | A RESEARCH REPORT SUBMITTED TO THE FACULTY OF HEALTH
SCIENCES, UNIVERSITY OF THE WITWATERSRAND, IN PARTIAL
FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF
PUBLIC HEALTH
JANUARY 2012 === 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
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