Management for health services delivery

Management of health facilities: Referral systems

Country experiences

  • Referral system in Nigeria: Study of a tertiary health facility
    T. M. Akande, 2004, Annals of African Medicine Vol. 3, No. 3; 2004: 130 – 133
    Most patients seen in this tertiary health facility were not referred resulting in overcrowding with problems that can be managed at lower levels, and wastge of highly skilled manpower time and equipment. Steps are needed to encourage clients to use primary and secondary health facilities, with disincentives for patients who bye-pass these levels.
    (4 pages, pdf 94KB)
  • The Weakest Link: Competence and Prestige as Constraints to Referral by Isolated Nurses in Rural Niger
    Paul Bossyn and Wim Van Lerberghe, 2004, Human Resources for Health, 2:1
    Passive patients, authoritarian attitudes of health staff; fear loss of power and prestige; diminishing referral costs and distance barriers not enough to correct failing referral systems; make referrals visibly worthwhile and for professional upgrading for more effective referral patterns.
    (8 pages, pdf 293KB)
  • Title: Health Referral System and Minimum Packages of Services, Philippines
    DOH Center for Health Development, Northern Mindanao. Presentation on the role and components of a referral system. (42 pages, pdf 537kb)
  • Paediatric referrals in rural Tanzania: the Kilombero District Study - a case series
    Fidel Font, Llorens Quinto, Honoraty Masanja, Rose Nathan, Carlos Ascaso, Clara Menendez, Marcel Tanner, Joanna Armstrong Schellenberg and Pedro Alonso, BMC International Health and Human Rights, 2002.
    Study of referrals as part of primary health care and the Integrated Management of Childhood Illness (IMCI) strategy in a district in southern Tanzania. Findings suggest that the decision to refer is generally appropriate, but that too few children are referred. (6 pages, pdf 239kb)