Further, the logistical influence of the long referral distances was registered.
Generally, other characteristics are found to be more important than outcome, such as GP referral and distance [ 16, 30, 41, 46, 64, 67].
Mothers who have been referred will be interviewed to obtain details of indications for referral in, distance travelled, time taken, transport and costs.
Challenges to the community midwifery programme include: unavailability of drugs, equipment and supplies, lack of transport for referrals, long distances and bad roads, limited funding, inadequate remuneration, lack of supportive supervision, heavy workload, high cost of registration fees, insecurity, TBAs and lack of refresher trainings.
The proportion varies with age, referral status, season, distance from the hospital and length of hospital stay (LOS).
Diminishing referral costs and distance barriers is not enough to correct failing referral systems.
13 The findings may not apply to other maternity units that do not offer the same care, referral pathways and distance to tertiary referral hospitals.
Within the study areas we excluded, for ethical reasons, clusters that were more than 5 km from a designated health facility where CHWs referred cases for special care to minimize non-completion of referral because of distance.
There was a trend towards fewer referrals with increasing distance from the service.> There was a wide spectrum of presenting problems (Table 2).
