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Maternal and newborn deaths during transportation to and between health facilities: results from a review of Global MPDSR reports

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The review confirmed that problems with transport and referral contribute to maternal and newborn deaths. The quality of MPDSR reports varied. Of the 77 MPDSR reports included in the review 65 identified included information related to transport and referral contributing to maternal and/or perinatal deaths.  How the data was recorded and categorized varied considerably making comparison impossible. Only five reports (Ethiopia 2017 and 2018, and Nepal 2019, 2020 and 2021) separated out deaths from home to facility or between facilities. 65 reports provided insights into contributing factors, actions taken, and recommendations about deaths occurring from home to health facilities, while 55 contained such information about deaths between health facilities. The three-delays model was widely used as a conceptual framework related to transport and referral but was used inconsistently.  

The speakers will then present work emerging from the EmONC Re-Envisioning Project on Referral Readiness that suggests that complicated challenges in referral between facilities can be better understood and responded to by looking at factors associated with transportation readiness, referral efficiency and coordination of care,  care during transport, financial accessibility of referral, family centred referral and inter-facility relational dynamics.  


Eleonora Mognato, Former Masters Student at LSHTM

Francesca Palestra, World Health Organization 

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