Management Strategies To Enhance Rapid Referral And Coordination In Emergency Maternity Care Evidence From Health Centers Comprising Administrative Specialists, General Practitioners, Family Physicians, Obstetricians And Gynecologists, And Nurses

Abstract

Background:
Timely referral and effective coordination are critical to improving outcomes in emergency maternity care. Delays in referral processes are linked to preventable maternal and neonatal morbidity and mortality, particularly in low-resource settings. Multidisciplinary collaboration among healthcare professionals—spanning administrative specialists, general practitioners, family physicians, obstetricians, and nurses—is essential for streamlining emergency responses. However, the evidence on effective management strategies to enhance referral and coordination remains fragmented.

Objective:
This systematic review aims to synthesize existing research on management strategies that enhance the speed and efficiency of referral and coordination in emergency maternity care, focusing on multidisciplinary interventions and health center-level practices.

Methods:
A comprehensive literature search was conducted across five major databases (PubMed, Scopus, Web of Science, CINAHL, and Cochrane Library) for studies published between 2020 and 2024. Eligible studies included those that reported on interventions or systems designed to improve emergency referral coordination in maternity care. Data were extracted and analyzed using a narrative synthesis approach, with quality appraisal conducted using Joanna Briggs Institute (JBI) tools.

Results:
Twenty-seven studies met the inclusion criteria, representing diverse healthcare contexts. Key strategies included the implementation of standardized referral protocols, use of mobile health (mHealth) tools, simulation-based team training, and appointment of referral coordinators. These interventions were associated with reductions in referral time, improved interprofessional communication, and enhanced compliance with emergency protocols. Common barriers identified included poor transport infrastructure, staff shortages, and lack of digital system interoperability.

Conclusion:
Multidisciplinary, well-coordinated management strategies significantly enhance the effectiveness of emergency maternity referral systems. Protocol-based interventions, digital communication tools, and regular interdisciplinary training emerged as critical enablers of timely care. Future research should explore the long-term impact, scalability, and cost-effectiveness of these strategies, particularly in resource-constrained settings.