|Question||No of studies||Evidence synthesis||Quality|
|Which methods of working ensure effective referral?||n = 2||
There is confusion between healthcare worker roles, particularly between midwives and physicians, which may impact on the effectiveness of referral.|
The partograph is not always used as a communication tool between health workers at handover of care or referral.
Partograph findings are not always acted upon.
|*V low [29, 32]|
|What are the issues or barriers related to effective referral?||n = 10||
The partograph is a trigger for referral. However, there is some inconsistency in referrals based on partograph findings.|
It is unclear if referrals made as a result of partograph use are appropriate.
There was little evidence of additional barriers to transfer, e.g., transport, cost etc.
**Low [23, 36, 38]|
*V low [20, 28, 29, 31, 32, 37, 39]