Chevening Leadership and Influence Essay Example: District maternal health referral coordinator

When 18% of high-risk pregnant women referred across my district missed follow-up last quarter, the problem was rarely clinical. Handovers between our five clinics, the community health worker network, and the referral hospital left responsibility unclear. As district maternal health referral coordinator, I chose to act rather than wait for a directive. I reviewed referral records across all five facilities and found information moved informally, with no consistent record of who had accepted a case. Sensitive details were sometimes shared in ways that could expose women at home. I redesigned the referral form so each handover step named an accountable staff member, and added a privacy rule allowing community workers to escalate without disclosing diagnoses to neighbours. Influencing colleagues mattered as much as the design. Some clinic nurses resented extra paperwork; some community workers feared privacy rules would slow them. I met each group separately, walked through three recent missed cases, and invited them to shape the form. A senior nurse added a tick-box for urgent cases; a community worker proposed a code for sensitive conditions. Resistance became practical input. Within three months, all five clinics adopted the revised process. Comparing the same case categories over two quarters, missed follow-ups among high-risk referrals fell from 18% to about 7%. A clinic supervisor said the named-owner field made vulnerable women easier to track; community workers said they finally knew when to escalate. In the UK I want to study implementation science and patient safety to learn how to measure and sustain such changes. On return, I will present the revised form and outcome log to our provincial maternal health technical working group, asking them to pilot it in one neighbouring district and review missed-follow-up rates after one quarter.