Critical Interpretive Synthesis of Current Evidence Regarding the Referral and Transport of Vulnerable Newborns in Low- and Middle-Income Countries

Location: Kenya

Alumni: Hannah Ray

Faculty: Kathleen Sobiech

In Kenya, barriers in the identification, referral, and transportation of preterm, low birth weight (LBW), or sick infants have not been adequately addressed. While national policies aiming to improve health outcomes have been implemented, there are still unaddressed challenges to the timely treatment of patients, resulting in an unacceptably high number of infant deaths from treatable causes. This paper interprets and integrates the findings from qualitative studies in low- and middle-income countries to understand the lived experiences and perceptions regarding the transport and referral processes of vulnerable infants from a variety of perspectives. Negative patient experiences were due to the lack of prioritization of their individual case. In resource-scarce environments, this is compounded by the fact that healthcare workers must continuously triage to serve large populations with inconsistent access to equipment, supervision, and other system-wide factors. We propose a conceptual model for systemic environmental turbulence that contributes to the progression of system-wide compassion fatigue, which identifies the effects of uncertainty on the workforce to address the challenges in delivering care at the Moi Teaching and Referral Hospital in Eldoret, Kenya.

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