Building referral mechanisms for neonatal care in humanitarian emergency settings: A systematic review

Spencer Rutherford, Maryan Naman, Nabila Zaka, Kathryn Michaux, Meghan A. Cupp, Hannah Hafezi, Samira Sami, Emma C. Alexander, Monica Lakhanpaul and Logan Manikam

International Journal of Health Planning and Management, 2023, vol. 38, issue 5, 1360-1376

Abstract: Aim During humanitarian emergencies, women and children are particularly vulnerable to health complications and neonatal mortality rates have been shown to rise. Additionally, health cluster partners face challenges in coordinating referrals, both between communities and camps to health facilities and across different levels of health facilities. The purpose of this review was to identify the primary referral needs of neonates during humanitarian emergencies, current gaps and barriers, and effective mechanisms for overcoming these barriers. Methods A systematic review was performed using four electronic databases (CINAHL, EMBASE, Medline, and Scopus) between June and August 2019 (PROSPERO registration number CRD42019127705). Title, abstract, and full text screening were conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. The target population was neonates born during humanitarian emergencies. Studies from high‐income countries and prior to 1991 were excluded. The STROBE checklist was used to assess for risk of bias. Results A total of 11 articles were included in the analysis; these were mainly cross‐sectional, field‐based studies. The primary needs identified were referrals from homes to health facilities before and during labour, and inter‐facility referrals after labour to more specialised services. Some of the main barriers included a lack of roads and infrastructure for transport, staff shortages—especially among more specialised services, and a lack of knowledge among patients for self‐referral. Mechanisms for addressing these needs and gaps included providing training for community healthcare workers (CHWs) or traditional birth attendants to identify and address antenatal and post‐natal complications; education programmes for pregnant women during the antenatal period; and establishing ambulance services in partnership with local Non‐Governmental Organizations. Conclusion This review benefited from a strong consensus among selected studies but was limited in the quality of data and types of data that were reported. Based on the above findings, the following recommendations were compiled: Focus on local capacity‐building programmes to address programmes acutely. Recruit CHWs to raise awareness of neonatal complications among pregnant women. Upskill CHWs to provide timely, appropriate and quality care during humanitarian emergencies.

Date: 2023
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://doi.org/10.1002/hpm.3655

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bla:ijhplm:v:38:y:2023:i:5:p:1360-1376

Ordering information: This journal article can be ordered from
http://www.blackwell ... bs.asp?ref=0749-6753

Access Statistics for this article

International Journal of Health Planning and Management is currently edited by Calum Paton

More articles in International Journal of Health Planning and Management from Wiley Blackwell
Bibliographic data for series maintained by Wiley Content Delivery ().