Examining Conditions of Health Referral Services in Public Health Facilities among Health Care Practitioners in Edo State

Abstract

The study examined health referral services in public health facilities in relations to pathways of health referral system, conditions of health communication between referring and referred health facilities, condition of patients’ health record transfer and follow up services among health care practitioners in Edo state. The cross-sectional survey design of the descriptive research design was used for the study. Four research questions were raised. The population of the study was drawn from health care providers from five health facilities across the three senatorial districts in Edo state which was estimated at 848 health care providers. The multistage sampling technique was used to select a sample of 150 health care practitioners. A structured questionnaires designed by the researcher was used for data collection as it relates to the research questions raised. The instrument was content validated by experts in Health Education and Health management from the University of Benin. The reliability of the instrument was ascertained using the test re-test reliability approach in which 20 copies of the validated instrument were administered and after a period of two weeks, the same instrument was re-administered to same respondents. The scores from the two administrations were analyzed using the analysis of Pearson Product Moment Correlation (PPMC) with SPSS to obtain the correlation coefficient. 0.79. The instrument was administered by the researcher with the help of four trained researcher assistants. Collected data were subjected to descriptive analysis of frequency and percentage. The findings revealed that the health referral pathway in health facilities in Edo state is the bottom up approach, the communication between referring and referred health facilities is weak, health record is conveyed alongside the referral form and the health record is demanded by the referred health facility, however, there is less evident of patient informed consent on the health record, a poor follow up services among the health care providers which is evident upon the lack of monitoring of adherence to health instruction and services. It was concluded that health referral system is important to the efficient delivery of health services to the people and the pathway, condition of health communication, health record transfer and follow up services coordination is essential for providing optimal health services and coverage to the populace. The study recommended that the government, health policy makers should maintain the two-way approach of the pathway to health referral system to ensure effective and efficient dynamics of health management and promote the top-bottom approach to decongest the high number of health seekers in the tertiary health care settings especially for simple health needs.