Institutional Factors Affecting Timely Referral and Safe Transport of Neonates in Makueni County Referral Hospital, Kenya

Abstract

Purpose: Internationally, 2.5 million babies lose their lives before first 28 days of life, many of the deaths occur in underdeveloped countries and a third occur on day one of life. According to the World Health Organization, many infant deaths are preventable by simple interventions. Some of the early interventions are proper preparedness and early identification of danger signs, timely referral, and safe transport of sick newborns to ensure reductions in newborn deaths. The purpose of this study was to identify institutional factors that affect timely referral and safe transport of neonates in Makueni County Referral Hospital.

Methodology: The study employed an analytic cross-sectional study design. The researcher collected data from 50 primary caregivers or the mothers. The researcher used a self-administered questionnaire, document reviews of the patients’ files, and a structured data checklist. Patients condition on admission was obtained from the patient’s file. The researcher analyzed the data quantitatively using the Statistical Package for Social Sciences version 26 (SPSS V26).

Results: According to the study findings, institutional characteristics highlight several significant factors associated with the likelihood of timely referral and safe transport during a referral. Patients who did not receive stabilization treatment were found to be more prone to experiencing a lack of timeliness and safe transport during referral (P=0.004), patients who did not undergo vital signs monitoring were 9.25 times more prone to experiencing delays and unsafe transportation (P = 0.035). The results suggest that patients with a response time exceeding 2 hours were more likely to face a lack of timeliness and safe transport during referral (P=0.032). The availability of an ambulance emerged as a significant factor, with 59.5% (25) reporting waiting for an ambulance as the reason for the delay.

Conclusion: The study concludes that institutional factors influenced safe transport and timely referral including stabilization treatment, vital signs monitoring, response time for referral, and the availability of an ambulance. The study recommends that ambulances should be availed timely, in adequate numbers, and be equipped with the necessary drugs and equipment so that in the event of a problem, the healthcare provider can intervene appropriately. Also, hospitals should be supplied with all the necessary equipment and drugs to aid in stabilization of patients.