Results
Table 1 presents descriptive statistics for the baseline sample
of 225 women referred from 20 RHFs to the two districts hospitals, CB
Dunbar (75.1%) and Phebe (24.8%). Of the 225, 93 (41.3%) women had
complete records and 132 (58.6%) women had records only from the
hospital. The most common reasons for referrals were obstructed labor
(33.3%), other (12%) which included premature rupture of membranes,
anemia, and previous CS (8%). Most women delivered via spontaneous
vaginal delivery (56.8%), with 18 women (8%) and 92 babies (40.8%)
experiencing complications. On average, women took 23 hours to get to
the hospital, after the referral was initiated at the RHF, with the
median being 5.8 hours and only 12.9% of the women arriving at the
hospital within two hours of less.
Endline data included 287 women with 159 (55.4%) complete records
(Table 2 ). Of the total sample, 155 (54%) women were referred to
CB Dunbar and 132 (46%) referred to Phebe. Similar to the baseline
sample, the most common reasons for referral among the endline sample
were obstructed labor (22.6%), previous CS (15.6%), and other
(12.8%). Less than half of the women delivered via spontaneous vaginal
delivery (41.4%), with 13 women (4.5%) and 67 babies (23.3%)
experiencing complications. The average time it took for women to arrive
at the district hospital following referral from the RHF was 32 hours,
with the median of 7.2 hours and 18 (11.3%) women arriving at the
hospital in 2 hours or less from time of referral.
Table 3 shows the association between timepoints, mode of
delivery, maternal outcome, newborn outcome, and transfer time. The
unadjusted model showed that women at endline were more likely to
undergo a CS (OR: 1.86; 95%CI: 0.99-3.46) compared to women at
baseline. There was no statistically significant association between
timepoints and maternal outcomes. Newborns at endline were significantly
less likely to be depressed (OR: 0.31; 95%CI: 0.14-0.68) compared to
newborns at baseline. Lastly, there was no statistical significance in
transfer time from RHF to hospital between baseline and endline.