ArticleBMC pregnancy and childbirth2020
Bypassing or successful referral? A population-based study of reasons why women travel far for childbirth in Eastern Uganda.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 38 citations in OpenAlex.
- Perceptions and experiences of women referred during obstetric complications in Eastern Uganda: A qualitative study.PLOS global public health · 2025Article
- Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women's Self-Reported Care-Seeking Pathways.Global health, science and practice · 2024Article
- Inequalities in the geographic access to delivery services in Brazil.BMC health services research · 2024Article
- Factors associated with bypassing primary healthcare facilities for childbirth among women in Devchuli municipality of Nepal.PloS one · 2024Article
- Article
- Choice of a family planning outlet in urban areas: The role of distance and quality of services in Kenya and Uganda.Frontiers in global women's health · 2023Article
- Self-referral practice and associated factors among women who gave birth in South Gondar zone primary hospitals, Northwest Ethiopia: a cross-sectional study design.Frontiers in public health · 2023Article
- Self-referrals and associated factors among laboring mothers at Dilla University Referral Hospital, Dilla, Gedeo Zone, Ethiopia: a cross-sectional study.BMC women's health · 2022Article
- Health care seeking in modern urban LMIC settings: evidence from Lusaka, Zambia.BMC public health · 2022Article
- Inequalities in effective coverage measures: are we asking too much of the data?BMJ global health · 2022Article
- Health Care Workers' Experiences, Challenges of Obstetric Referral Processes and Self-Reported Solutions in South Western Uganda: Mixed Methods Study.Risk management and healthcare policy · 2022Article
- Distance matters: barriers to antenatal care and safe childbirth in a migrant population on the Thailand-Myanmar border from 2007 to 2015, a pregnancy cohort study.BMC pregnancy and childbirth · 2021Article
- An assessment of geographical access and factors influencing travel time to emergency obstetric care in the urban state of Lagos, Nigeria.Health policy and planning · 2021Article
- Influence of travel time and distance to the hospital of care on stillbirths: a retrospective facility-based cross-sectional study in Lagos, Nigeria.BMJ global health · 2021Article
- Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey.BMC health services research · 2021Article
- Critical comparative analysis of data sources toward understanding referral during pregnancy and childbirth: three perspectives from Nigeria.BMC health services research · 2021Article
- The status of emergency obstetric and newborn care in post-conflict eastern DRC: a facility-level cross-sectional study.Conflict and health · 2021Article
- Institutionalizing a Regional Model for Improving Quality of Newborn Care at Birth Across Hospitals in Eastern Uganda: A 4-Year Story.Global health, science and practice · 2021Article
- The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal.Journal of global health · 2021Article
- "In cities, it's not far, but it takes long": comparing estimated and replicated travel times to reach life-saving obstetric care in Lagos, Nigeria.BMJ global health · 2021Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundDelivery in a facility with a skilled health provider is considered the most important intervention to reduce maternal and early newborn deaths. Providing care close to people's homes is an important strategy to facilitate equitable access, but many women are known to bypass the closest delivery facility for a higher level one. The aim of this study was to investigate to what extent mothers in rural Uganda bypassed their nearest facility for childbirth care and the determinants for their choice.
methodsThe study used data collected as part of the Expanded Quality Management Using Information power (EQUIP) study in the Mayuge District of Eastern Uganda between 2011 and 2014. In this study, bypassing was defined as delivering in a health facility that was not the nearest childbirth facility to the mother's home. Multilevel logistic regression was used to model the relationship between bypassing the nearest health facility for childbirth and the different independent factors.
resultsOf all women delivering in a health facility, 45% (499/1115) did not deliver in the nearest facility regardless of the level of care. Further, after excluding women who delivered in health centre II (which is not formally equipped to provide childbirth care) and excluding those who were referred or had a caesarean section (because their reasons for bypassing may be different), 29% (204/717) of women bypassed their nearest facility to give birth in another facility, 50% going to the only hospital of the district. The odds of bypassing increased if a mother belonged to highest wealth quintile compared to the lowest quintile (AOR 2.24, 95% CI: 1.12-4.46) and decreased with increase of readiness of score of the nearest facility for childbirth (AOR = 0.84, 95% CI: 0.69-0.99).
conclusionsThe extent of bypassing the nearest childbirth facility in this rural Ugandan setting was 29%, and was associated primarily with the readiness of the nearest facility to provide care as well as the wealth of the household. These results suggest inequalities in bypassing for better quality care that have important implications for improving Uganda's maternal and newborn health outcomes.
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