Proportion, Characteristics and Maternal Outcome of women referred for childbirth to a tertiary hospital in northern Tanzania – A descriptive retrospective study based on a hospital birth registry

Carolyn A. Lissu a,b, Helena Volgsten c,d,*, Festo Mazuguni b, Eusebious Maro b,e
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Timely identification of danger signs and prompt referral to higher level may prevent complication associated with childbirth. With a high MMR in Tanzania, there is need to highlight the information on the proportion of women referred to tertiary healthcare, their basic characteristics and outcomes. This study aimed to determine the proportion, basic characteristics and outcomes among women referred while in labour, from lower health facilities to a tertiary hospital in northern Tanzania.


A descriptive retrospective study based on a hospital birth registry was conducted using consecutive stored data on pregnant women referred while in labour and managed at a tertiary hospital in northern Tanzania, between the years 2000 and 2015.


During the study period, a total of 53,662 deliveries were managed. Among these, 6066 women were referred from lower health facilities, with 4193 (69.2%) of them being referred while in labour. The main reason for referral was poor progress of labour (31.0%), followed by prolonged labour (27.1%) and obstructed labour (19.5%). The rate of caesarean section was 44.6%. A total of 292 maternal deaths occurred between 2000 and 2015. Of these, almost a quarter (22.6%) occurred in women referred from other health facilities while in labour.


Majority of referred women while in labour from lower health facilities are linked to maternal complications associated with childbirth. This underscores the need to further explore the competence of lower health facilities to quickly detect complications and provide effective emergency obstetric care, as well as timely referral to higher-level facility.