Challenges of health workers in primary health facilities in implementing obstetric emergency referrals to save women from death in Indonesia: A qualitative study

Midwives, as health workers in primary healthcare, are expected to be skilled in addressing various challenges due to their close relationships with women at the forefront of the referral system. Enhancing competence in basic obstetric emergency care, improving communication between health facilities, and encouraging community empowerment are essential. Therefore, effective referrals from these improvements would enable women to receive timely and comprehensive obstetric emergency care. This study provides a foundational framework for developing interventions in health facilities and the community to strengthen the referral system and reduce maternal mortality in Indonesia.