ArticleBMJ open2019
Healthcare providers' perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Recommendations for improving maternal health services in Indonesian primary care under the COVID-19 pandemic: Results of a systematic review and appraisal of international guidelines.Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives · 2023Pooled it
- Effects of the World Health Organization Safe Childbirth Checklist on Quality of Care and Birth Outcomes in Aceh, Indonesia: A Cluster-Randomized Clinical Trial.JAMA network open · 2021Trial
- Obstetric referral practices and health system factors in public health centres of Addis Ababa, Ethiopia: A mixed-methods study.PloS one · 2026Article
- Compliance to recommended intra-partum management protocols of high-risk pregnancies among mothers in the Sunderbans: A mixed method study.Journal of family medicine and primary care · 2025Article
- Half of the mothers had poor delivery referral practices in public hospitals of Bahir Dar City Northwest, Ethiopia.Frontiers in public health · 2025Article
- Perceived barriers to management of patients with diabetes mellitus and hypertension in primary care centers in Indonesia.Frontiers in health services · 2025Article
- Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review.BMC women's health · 2024Article
- Challenges of health workers in primary health facilities in implementing obstetric emergency referrals to save women from death in Indonesia: A qualitative study.Belitung nursing journal · 2024Article
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- Exploring networks of care in implementing midwife-led birthing centres in low- and middle-income countries: A scoping review.PLOS global public health · 2023Article
- Mothers' Perceptions of the Quality of Postnatal Care Provided in Health Centers and the Associated Factors: A Cross-Sectional Study.International journal of community based nursing and midwifery · 2022Article
- Predictors of patients' choice of hospitals under universal health coverage: a case study of the Nicaraguan capital.BMC health services research · 2021Article
- Hypertensive disorders of pregnancy (HDP) management pathways: results of a Delphi survey to contextualise international recommendations for Indonesian primary care settings.BMC pregnancy and childbirth · 2021Article
- Trends and sociodemographic inequalities in the use of caesarean section in Indonesia, 1987-2017.BMJ global health · 2020Article
- The elephant in the room: an exploratory study of hypertensive disorders of pregnancy (HDP) management in Indonesian primary care settings.BMC family practice · 2020Article
- A protocol study of participatory action research: integrated care pathway for pregnant women with heart disease in Indonesia.BMC health services research · 2020Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOur study investigates the barriers perceived by staff in the referral systems in maternal healthcare facilities across Aceh province in Indonesia.
designWith a cross-sectional approach, two sets of surveys were administered during September to October 2016 in 32 sampling units of our study. We also collected referral data in the form of the frequency of ingoing and outgoing referral cases per facility.
settingIn three districts, Aceh Besar, Banda Aceh and Bireuen, a total of 32 facilities including hospitals, community health centres, and private midwife clinics that met the criteria of providing at least basic emergency obstetric and neonatal care (BEonC) were covered.
participantsAcross the 32 healthcare centres, 149 members of staff (mainly midwives) agreed to participate in our surveys. PRIMARY AND SECONDARY OUTCOME MEASURES: The first survey consisted of 65 items focusing on organisational measures as well as case numbers for example, patient counts, mortality rate and complications. The second survey with 68 items asked healthcare providers about a range of factors including attitudes towards the referral process in their facility and potential barriers to a well-functioning system in their district.
resultsOverall, mothers'/families' consent as well as the complex administration process were found to be the main barriers (36% and 12%, respectively). Healthcare providers noted that information about other facilities has the biggest room for improvement (37%) rather than transport, timely referral of mothers and babies, or the availability of referral facilities.
conclusionsThe largest barrier perceived by healthcare providers in our study was noted to be family consent and administrative burden. Moreover, lack of information about the referral system itself and other facilities seemed to be affecting healthcare providers and mothers/families alike and improvements perhaps through a shared information system is needed.
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