Managing Complications in Pregnancy and Childbirth: - IAWG

C-80 Provider and community linkages• provides a comfortable place for the woman and/or her newborn(e.g. lower delivery bed, warm and clean room).With careful planning, the facility can create this environment withoutinterfering with its ability to respond to complications or emergencies.IMPROVING REFERRAL PATTERNSEach woman who is referred to the district hospital should be given astandard referral slip containing the following information:• general patient information (name, age, address);• obstetrical history (parity, gestational age, complications in theantenatal period);• relevant past obstetrical complications (previous caesareansection, postpartum haemorrhage);• the specific problem for which she was referred;• treatments applied thus far and the results of those treatments.The referral slip should also include the outcome of the referral. Thereferral slip should be sent back to the referring facility with thewoman or the person who brought her. Both the district hospital andthe referring facility should keep a record of all referrals as a qualityassurance mechanism:• Referring facilities can assess the success and appropriateness oftheir referrals;• The district hospital can review the records for patterns indicatingthat a provider or facility needs additional technical support ortraining.PROVIDING TRAINING AND SUPPORTIVE SUPERVISIONDistrict hospitals should offer clinical training for peripheral providersthat is high-quality and participatory. Participatory training is skillfocusedand is more effective than classroom-based training because it:• improves the relationship between providers at the district hospitaland the auxiliary and multipurpose workers from peripheral units;