A health systems analysis of non-compliance to the maternity referral system by health facilities in Uganda: Findings from a mixed-methods study

Introduction A fully functional referral system is central to achieving quality maternal and newborn care. In 2018, Uganda established Kawempe National Referral hospital (KRNH) as the highest level of care for maternity services. There is a dearth of data examining if the referral function for which it was established has been met. The objectives of this study were two fold; i) to assess the appropriateness of in-coming referrals at KRNH ii) to examine factors underpinning referral decisions at lower referring facilities across Uganda.