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Background: Three-quarters of maternal deaths can be prevented by proper emergency referral procedures, early recognition of obstetric complications, and timely and adequate care.Nonetheless, lots of women still experience difficulties getting the life-saving emergency obstetric interventions they need promptly.Aim: Aim to improve maternal service delivery at the highest referring catchment health center to a tertiary teaching hospital through establishing a comprehensive obstetric care from December 2020 to April 2022.Methods: A pre and post-intervention follow-up study design was employed to evaluate the impact of a quality improvement project at a health center on the access and quality of maternal service.After identifying a highly referring catchment health center, we established a multidisciplinary team responsible for preparing a readiness plan, facilitating staff training on obstetric care, resource mobilization, and continuous supportive supervision.Results: Caesarian section delivery, holistic obstetric ultrasound service, and comprehensive abortion care were started at the catchment health center.The total monthly delivery at the health center almost quadrupled from 94 to an average of 334, referral out decreased from 156 mothers to a median of 12, and maternal emergency referral-in to the health center from the surrounding health centers increased from zero to a median of 44 mothers.The total number of deliveries at the tertiary hospital decreased from a monthly average of 902 to 827.Conclusion: Delivering comprehensive obstetric care near the client's home by empowering the catchment health center has a significant role in reducing unnecessary referrals and costs, overcrowding of tertiary hospitals, and increasing antenatal and postnatal care attendance and institutional delivery.Strengths and Limitations: Meticulous application of the science of improvement, data interpretation and analysis, and data driven decision-making are the strengths.Being tested in a single health center might make its generalizability questionable and needs further testing on a larger scale.
Teferi et al. (Fri,) studied this question.