ArticleBMJ global health2018
Addressing the third delay: implementing a novel obstetric triage system in Ghana.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Enhancing maternal and newborn outcomes in Ghana: a comprehensive randomized controlled trial evaluation of obstetric triage effectiveness and midwives training.BMC health services research · 2025Trial
- Determinants of Delays in Receiving Labor and Delivery Care at Health Facilities: An Analysis of the 2021 Nepal Health Facility Survey.Maternal and child health journal · 2026Article
- "Reimaging a triage system with midwives, for midwives": exploring preferences for a midwife-Led triage system in South Africa through a user-centered approach.Frontiers in digital health · 2026Article
- Effectiveness and Implementation of Obstetric Triage During Pregnancy and Childbirth: A Systematic Review.Cureus · 2025Review
- Enhancing emergency obstetric care navigation through a 'Welcome Person' model: insights from a health system strengthening initiative in Bangladesh.Journal of global health · 2025Article
- Implementation, effectiveness, and barriers of obstetric triage in reducing waiting time: a scoping review.Reproductive health · 2025Article
- Reasons for maternal near-miss in Bahir Dar city administration, northwest Ethiopia: a qualitative interview approach using socio-ecological model.Frontiers in global women's health · 2025Article
- Implementation of a Technology-Based Mobile Obstetric Referral Emergency System (MORES): Qualitative Assessment of Health Workers in Rural Liberia.JMIR mHealth and uHealth · 2024Article
- Quality improvement initiative: improving obstetric triaging practices in a rural maternal hospital in central India.BMJ open quality · 2024Article
- Implementation matters: assessing the effectiveness and sustainment of an obstetric triage program at a high-volume facility in Ghana.Implementation science communications · 2023Article
- The "No bed syndrome" in Ghana - what, how and why? A literature, electronic and print media review.Frontiers in health services · 2023Review
- Acceptability of a Whatsapp Triage, Referral, and Transfer System for Obstetric Patients in Rural Liberia.Annals of global health · 2023Article
- Frequency and impact of long wait times for family planning in public-sector healthcare facilities in Western Kenya.Global health action · 2022Article
- Barriers and enablers to emergency obstetric and newborn care services use in Wolaita Zone, Southern Ethiopia: a qualitative case study.BMC public health · 2022Article
- Diversifying Implementation Science: A Global Perspective.Global health, science and practice · 2022Article
- Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea.Scientific reports · 2022Article
- Actions and Adaptations Implemented for Maternal, Newborn and Child Health Service Provision During the Early Phase of the COVID-19 Pandemic in Lagos, Nigeria: Qualitative Study of Health Facility Leaders.Annals of global health · 2022Article
- Midwife-performed checklist and ultrasound to identify obstetric conditions at labour triage in Uganda: A quasi-experimental study.Midwifery · 2021Article
- Assessing the functionality of an emergency obstetric referral system and continuum of care among public healthcare facilities in a low resource setting: an application of process mapping approach.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15-100) to 5 min (2-6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.
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