Quality of Emergency Obstetric Referral Practice and Associated Factors Among Mothers Referred to Public Heath Facility in Jimma Zone South West Ethiopia

Abstract

Abstract Background: One of the important aspects of health care facilities is the referral system, especially in the case of obstetric emergencies. Implementation of a well-managed and functional referral system leads to good health care quality. The referral system is an important public health issue. Timely and appropriate emergency obstetric referral to a suitable health facility is an indicator of effective health systems. Even though quality referral is a subject of paramount importance for health care organizations, to the best of our knowledge there is no studies are done so far in Ethiopia. Objectives: To assess quality of emergency obstetric referral practice and associated factor among mothers referred to public health facility in Jimma zone south west Ethiopia. Methods: Facility based cross-sectional study was conducted in three randomly selected public hospitals in Jimma zone. The data was collected from total of 396 participants with response rate of 98% from August 20, 2021 to October 20, 2021; through observation, interview and record review Data was entered into Epi-data Version 3.1 and exported to SPSS version 23 for further analysis. Result: Quality of emergency obstetric referral practice was poor in 206(52%). Out of referred clients 77.3% sent with standard referral paper, 68.9 have been provided transportation and 60.6 % pre referral communication of health professionals, 39.1% was sent without escorting health professional, 59.8% have community-based health insurance. Concerning referral papers, the most recorded item was the name of referring health facility in 92.4%, date of referral was recorded in 76.3%. The structural part of referral practice was good in only 44.7% and patient satisfaction was good in 48.2% of referral. Being illiterate husband decreases quality of emergency obstetric referral practice by 36% as compared to husband has higher educational level with P-value of 0.021(AOR=0.360, 95%CI= 0.127-1.021). Being primiparous decreases quality of emergency obstetric referral practice by 55.3% compared to being multiparous with P-value of 0.032 (AOR= 0.553 95%CI=0.321- 0.950). Ages between 25-34 increases quality of emergency obstetric referral practice by 40.9% compared to ages greater than 40 with p- value 0.021 (AOR =0.409 95%CI= 0.195-0.045). Conclusion and recommendation: The quality of a referral practice of public health facility was poor. So, special attention should be given by government and other stake holdersto increase communication between health facilities, transport arrangement, and educational level of husbands.