Main Article Content
Reasons and outcome of paediatric referrals from first-level health facilities in Sabongari, Zaria, Northwestern Nigeria
Abstract
Methods: A cross-sectional descriptive study was carried out in six sampled public first-level health facilities in Sabon Gari Local Government Area of Kaduna State in the Northwest zone of Nigeria. A total of 106 under-five children referred during the sixteen-week study period from the six sampled health facilities were studied. Structured questionnaires and a two-way referral form were designed and used for data collection and the children followed up to determine the type of care received and its outcome.
Results: Diarrhoea was the most common reason for referral (34%) followed by convulsion (10.4%), difficulty in breathing (8.5%) and surgery (8.5%). The most important reason for the decision to refer was for better diagnosis and treatment (70.8%). The referral compliance rate was 37.8%. Of those that complied, 31 (83.8%) of them recovered, 6 (16.2%) died and none had a disability (P > 0.05). Of the 61 (62.2%) of the referrals that did not comply, the majority (65.6%) of them were treated by traditional healers while 34.4% were managed at home using home-based remedies. The compliant referrals were found to significantly have more favourable outcomes than the non-compliant cases. Factors that influenced the referral outcomes included compliance, transport difficulty, financial constraints and husband\'s consent.
Conclusion: Referral to a higher level of care where there are better facilities for diagnosis and treatment generally improve the chances of a favourable outcome.There is a need for adequate investment in resources at first-level health facilities to make referrals worthwhile and more effective.
Key Words: Child illness; Referral; First-level health facilities; Reasons; Outcome
Journal of Community Medicine & Primary Health Care Vol.16(1) 2004: 10-15