ArticleBMC health services research2025
"Attitude is the fifth delay": perspectives of obstetric near-miss survivors and health care professionals on continuity and coordination of maternal care.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Risk stratification and prediction of emergency delivery in early-onset preeclampsia using machine learning.BMC medical informatics and decision making · 2025Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFragmentation in maternal healthcare contributes to preventable maternal deaths. Improving continuity and coordination can mitigate this issue by influencing interactions among providers, interdisciplinary teams, and patient-provider relationships. The obstetric near-miss approach has the potential to offer insights into continuity and coordination in maternal health. The aim of this study was to explore the perspectives of near-miss survivors and health care professionals on continuity and coordination of care in a primary health care system in Uasin Ngishu region, Kenya.
methodsThis was a descriptive qualitative single case study. Data was collected through individual interviews, focus group discussions, and observation.
resultsFour deductively identified themes emerged: sequential coordination, continuity, parallel coordination, and access. Sequential coordination was influenced by antagonistic relationships between healthcare providers in primary care facilities and the main referral hospital. Longitudinal and interpersonal continuity were driven by positive interactions between women and healthcare providers, characterized by availability, willingness to listen, and addressing personal issues. Parallel coordination was affected by heavy workloads and ineffective task shifting within primary care facilities. Finally, access-related issues included accommodation strategies such as telephone hotlines for pregnant women, out-of-pocket payments for specialist consultation, and alternative referral pathways different from the formal pathways in the health system.
conclusionTo promote continuity and coordination in primary health care for pregnant women, there is a need to focus on social competencies and skills among health care professionals providing obstetric care, encourage accommodation strategies in facilities, reduce or eliminate out-of-pocket payments for referred women, address attitude and professional conflicts among midwives at different levels in the referral pathway and address workloads and task shifting in primary care facilities.
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