Abstract:
This was a hospital based descriptive study to assess the magnitude of bypass and to identify
the factors influencing this phenomenon. This was conducted at the GH Kurunegala from 6
th to the 27 th of July 1993. The findings of the study indicated that 35 per cent of the
mothers admitted to GH Kurunegala have bypassed a primary level natal care institution
closest to their residence. There was over-crowding and over-utilization of natal care
services observed at GH Kurunagela. It was evident that this was due to the fact that there
was no admission policy, referral or back -referral system operating at this institution. There
was no significance associated observed between the distance travelled to GH Kurunegal,
and the education level, family income or the employment status of the mother at 5 per cent
level. There was also no association observed between the employment status of the
husband and the distance travelled to the GH Kurunegala at 5 per cent significance level.
The antenatal care received by mothers have been above the approved quality and coverage
as revealed by the indicators, and, to the satisfaction of the mothers. All these indicators of
antenatal care were above 90 per cent coverage. A surprising feature observed in this study
was 56 per cent of the mothers have been advised by the field midwife to gain admission to
GH Kurunegala for delivery
