The Effectiveness of Referral Back Sheets on Early Detection of High Maternal Risk in the Work Area of Subang Health Department

Leri  Septiani; Yanti  Herawati; Hidayat  Wijayanegara; Siti Sugih Hartiningsih

Authors

Leri Septiani STIKes Dharma Husada, Bandung, Indonesia
Yanti Herawati STIKes Dharma Husada, Bandung, Indonesia
Hidayat Wijayanegara STIKes Dharma Husada, Bandung, Indonesia
Siti Sugih Hartiningsih STIKes Dharma Husada, Bandung, Indonesia

Keywords:

Pre-Referral Back Sheet, Early Detection, Maternal High Risk.

Abstract

Maternal health is an important aspect of the health care system, as the quality of maternal health has a direct impact on the well-being of the mother and her unborn child. High maternal risk refers to conditions that increase the potential for complications during pregnancy, labor and postpartum. Early identification of high maternal risk is crucial to provide appropriate care and reduce the risk of complications that can harm both mother and baby. One tool that can be used to support early detection of high maternal risk is the Pre-Referral Back Sheet (PRBS). PRBS is an instrument that presents a collection of questions or certain parameters that must be filled in by health workers, especially midwives during prenatal examinations. It is designed to identify risk factors and early symptoms that may indicate potential maternal high risk. Although the LBPR has been integrated into maternal health care practice, no in-depth study has specifically evaluated its effectiveness in early detection of maternal high risk. Therefore, this study aimed to evaluate the effectiveness of the Pre-Referral Back Sheet in early detection of maternal high risk and identify the extent to which this tool can improve the quality of maternal health care. This study used an observational method with a cross-sectional approach with a sample of 450 pregnant women who attended prenatal examinations at selected health centers. Of the total 450 respondents, the majority were pregnant women of reproductive age (20-35 years) with an average age of 28 years. 60% of respondents had secondary education, and 80% lived in urban areas. The prevalence of maternal high risk in the Subang Health Office Working Area was found to be 18%, based on the criteria identified by the LBPR. Statistical analysis showed that the use of LBPR significantly improved early detection of maternal high risk. The sensitivity of LBPR reached 75%, with a specificity of 85%. These results indicate that the LBPR can identify most maternal high-risk cases with good accuracy. Based on these findings, it can be concluded that the Pre-Referral Back Sheet (LBPR) is effective in early detection of maternal high risk in the Subang Health Office Working Area. The use of LBPR can improve the quality of maternal health services and contribute positively to efforts to prevent and manage high maternal risk.

References

Ameyaw, E. K., Njue, C., Tran, N. T., & Dawson, A. (2020). Quality and women’s satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: a systematic review. BMC pregnancy and childbirth, 20, 1-16.

Ameyaw, E. K. (2021). Maternal Referral Systems in the Northern Region of Ghana (Doctoral Dissertation).

Amoakoh-Coleman, M., Klipstein-Grobusch, K. K., Vidzro, E. S., Arhinful, D. K., & Ansah, E. K. (2022). Obstetric referral processes and the role of inter-facility communication: the district level experience in the Greater Accra region of Ghana. Ghana Medical Journal, 56(3), 51-60.

Avoka, C. K., McArthur, E., & Banke‐Thomas, A. (2022). Interventions to improve obstetric emergency referral decision making, communication and feedback between health facilities in sub‐Saharan Africa: A systematic review. Tropical Medicine & International Health, 27(5), 494-509.

Bartels, S. M., & Mortenson, B. P. (2006). Enhancing adherence to a problem-solving model for middle-school pre-referral teams: A performance feedback and checklist approach. Journal of Applied School Psychology, 22(1), 109-123.

Dinas Kesehatan Kabupaten Subang. (2017). Profil Kesehatan. Retrieved from; https://diskes.jabarprov.go.id/assets/unduhan/13.%20Profil%20Subang_2016.pdf

Finch, L. A. (2020). Assessing the Perceived Effectiveness and Acceptability of Pre-Referral Intervention Team Procedures by School Teams: Continued Validation of the Pre-Referral Intervention Team Inventory. Minnesota State University, Mankato.

Gunanti, I. R., Devi, S. R., & Adriani, M. (2005). Pemberdayaan kader posyandu melalui penerapan metode konseling gizi dalam upaya meningkatkan kualitas pembinaan program keluarga sadar gizi (KADARZI). Buletin Penelitian Sistem Kesehatan, 8(1), 21117.

Karim, F., Soepardan, S., Komalaningsih, S., Wijayanegara, H., Sastramihardja, H., & Rowawi, R. (2019). Pengaruh Penerapan Pra Rujukan Menggunakan Lembar Balik Terhadap Peningkatan Pengetahuan Dan Sikap Bidan Dalam Deteksi Dini Risiko Tinggi Maternal Di Beberapa Puskesmas Kabupaten Subang. Jurnal Sistem Kesehatan, 5(2).

Kelley, B. E. (2007). Factors that influence the referral of elementary African American males to special education: A reflection of the pre-referral process. Edgewood College.

Kovaleski, J. F. (2002). Best practices in operating pre-referral intervention teams. Best practices in school psychology IV, 1, 645-655.

Lhospital, A. S., & Gregory, A. (2009). Changes in teacher stress through participation in pre‐referral intervention teams. Psychology in the Schools, 46(10), 1098-1112.

Moreno, G., & Gaytán, F. X. (2013). Reducing subjectivity in special education referrals by educators working with Latino students: Using functional behavioral assessment as a pre-referral practice in student support teams. Emotional and Behavioural Difficulties, 18(1), 88-101.

Oktarina, O., & Sugiharto, M. (2015). The Relationships Among Knowledge, Attitude, and Compliance of Gravida (Expectant Mothers) and the Utilization of Maternal and Child Health (MCH) Book at Puskesmas Geger and Kedundung in Bangkalan, East Java, Year 2013. Buletin Penelitian Sistem Kesehatan, 18(2), 20937.

Ofosu, B., Ofori, D., Ntumy, M., Asah-Opoku, K., & Boafor, T. (2021). Assessing the functionality of an emergency obstetric referral system and continuum of care among public healthcare facilities in a low resource setting: an application of process mapping approach. BMC health services research, 21(1), 1-14.

Pandya, H., & Iyengar, S. Emergency referral: a critical component of maternal and newborn survival.

Rahma, M. (2015). Asuhan Berkesinambungan untuk Meningkatkan Kesehatan Ibu dan Bayi di Kabupaten Subang. Jurnal Bidan, 2(1), 234052.

Samiksha, S., Doyle, P., Campbell, O. M., Mathew, M., & Murthy, G. V. S. (2016). Referrals between public sector health institutions for women with obstetric high risk, complications, or emergencies in India-a systematic review. PLoS ONE, 11(8).

Sasmita, A. (2018). Penggunaan Lembar Balik Pintar (Lembapin) Terhadap Pengetahuan Dan Keterampilan Kader Dalam Menentukan Hasil Penimbangan dan Penyuluhan Berdasarkan KMS di Posyandu Wilayah Puskesmas Srandakan (Doctoral dissertation, Poltekkes Kemenkes Yogyakarta).

Young, H. L., & Gaughan, E. (2010). A multiple method longitudinal investigation of pre-referral intervention team functioning: Four years in rural schools. Journal of Educational and Psychological Consultation, 20(2), 106-138.