The study conducted in rural Burundi found that the establishment of an ambulance referral network significantly improved access to emergency obstetric and neonatal care (EmONC). Here are the key findings from the study:
1. Communication and Ambulance Service: Médecins sans Frontières (MSF) set up an ambulance referral system in 2006, connecting peripheral maternity units to a central referral facility through 1.6 ambulances. In 2011, there were 1478 ambulance call-outs.
2. Referral Times: The median referral time from the maternity unit calling for an ambulance to the patient arriving at the MSF referral facility was 78 minutes. Referral times exceeding 3 hours were associated with a significantly higher risk of early neonatal deaths.
3. Cost: The total annual cost of the referral system was €85,586. The cost per obstetric case transferred was €61, and the cost per capita per year was €0.43.
4. Impact on Coverage: The referral service improved coverage of complicated obstetric cases and caesarean sections. MSF estimated that they covered 80% of complicated obstetric cases and 92% of caesarean sections.
In conclusion, the establishment of an ambulance referral network effectively improves access to emergency obstetric and neonatal care. This innovation ensures timely transportation of women with obstetric complications from peripheral maternity units to a central referral facility, reducing referral delays and improving maternal and neonatal outcomes. The study provides evidence for the feasibility and impact of this approach in a rural setting with high maternal mortality.
AI Innovations Description
The recommendation to improve access to maternal health is the establishment of an ambulance referral network. This innovation involves creating a system where peripheral maternity units are linked to a central referral facility through ambulances. The study conducted in rural Burundi showed that this referral system significantly improved access to emergency obstetric and neonatal care (EmONC).
Key findings from the study include:
1. Communication and Ambulance Service: Médecins sans Frontières (MSF) established an ambulance referral system in 2006, which involved 1.6 ambulances linked with nine maternity units. In 2011, there were 1478 ambulance call-outs.
2. Referral Times: The median referral time from the maternity unit calling for an ambulance to the patient arriving at the MSF referral facility was 78 minutes. Referral times exceeding 3 hours were associated with a significantly higher risk of early neonatal deaths.
3. Cost: The total annual cost of the referral system was €85,586. The cost per obstetric case transferred was €61, and the cost per capita per year was €0.43.
4. Impact on Coverage: The referral service improved coverage of complicated obstetric cases and caesarean sections. MSF estimated that they covered 80% of complicated obstetric cases and 92% of caesarean sections.
In conclusion, the establishment of an ambulance referral network can effectively improve access to emergency obstetric and neonatal care. This innovation ensures timely transportation of women with obstetric complications from peripheral maternity units to a central referral facility, reducing referral delays and improving maternal and neonatal outcomes.
AI Innovations Methodology
To simulate the impact of the ambulance referral network on improving access to maternal health, the following methodology can be used:
1. Study Design: Conduct a retrospective cohort study to compare the outcomes of women with obstetric complications before and after the implementation of the ambulance referral network. Collect data from the period before the network was established as well as after its implementation.
2. Study Population: Include women with obstetric complications who sought care at peripheral maternity units in the Kabezi district, rural Burundi. Ensure that the sample size is representative of the population and includes a sufficient number of cases to detect significant differences.
3. Data Collection: Collect data on various variables, including referral times, maternal and early neonatal deaths, and the number of complicated obstetric cases and caesarean sections. Use ambulance log books, patient registers, and logistics records to obtain accurate and reliable information.
4. Analysis: Analyze the data using appropriate statistical methods. Calculate the median referral time and interquartile range to assess the efficiency of the referral system. Use logistic regression to examine the association between referral times and maternal and early neonatal deaths. Estimate the coverage of complicated obstetric cases and caesarean sections to evaluate the impact of the referral service.
5. Cost Analysis: Calculate the total annual cost of the referral system, including the cost per obstetric case transferred and the cost per capita per year. This analysis will provide insights into the financial implications of implementing and maintaining the ambulance referral network.
6. Interpretation: Interpret the findings of the study, considering the statistical significance of the results and the practical implications for improving access to maternal health. Discuss the strengths and limitations of the study, as well as any recommendations for further research or improvements to the ambulance referral network.
By following this methodology, researchers can assess the impact of the ambulance referral network on improving access to emergency obstetric and neonatal care in rural Burundi. The findings will provide valuable insights for policymakers and healthcare providers to enhance maternal health services and reduce maternal and neonatal mortality rates.
