Cargando…

A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda

Over 50% of sick children are treated by private primary-level facilities, but data on patient referral processes from such facilities are limited. We explored the perspectives of healthcare providers and child caretakers on the referral process of children with common childhood infections from priv...

Descripción completa

Detalles Bibliográficos
Autores principales: Mwanga-Amumpaire, Juliet, Kalyango, Joan Nakayaga, Ndeezi, Grace, Rujumba, Joseph, Owokuhaisa, Judith, Stålsby Lundborg, Cecilia, Alfvén, Tobias, Obua, Celestino, Källander, Karin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618635/
https://www.ncbi.nlm.nih.gov/pubmed/34828709
http://dx.doi.org/10.3390/children8110996
_version_ 1784604795389083648
author Mwanga-Amumpaire, Juliet
Kalyango, Joan Nakayaga
Ndeezi, Grace
Rujumba, Joseph
Owokuhaisa, Judith
Stålsby Lundborg, Cecilia
Alfvén, Tobias
Obua, Celestino
Källander, Karin
author_facet Mwanga-Amumpaire, Juliet
Kalyango, Joan Nakayaga
Ndeezi, Grace
Rujumba, Joseph
Owokuhaisa, Judith
Stålsby Lundborg, Cecilia
Alfvén, Tobias
Obua, Celestino
Källander, Karin
author_sort Mwanga-Amumpaire, Juliet
collection PubMed
description Over 50% of sick children are treated by private primary-level facilities, but data on patient referral processes from such facilities are limited. We explored the perspectives of healthcare providers and child caretakers on the referral process of children with common childhood infections from private low-level health facilities in Mbarara District. We carried out 43 in-depth interviews with health workers and caretakers of sick children, purposively selected from 30 facilities, until data saturation was achieved. The issues discussed included the process of referral, challenges in referral completion and ways to improve the process. We used thematic analysis, using a combined deductive/inductive approach. The reasons for where and how to refer were shaped by the patients’ clinical characteristics, the caretakers’ ability to pay and health workers’ perceptions. Caretaker non-adherence to referral and inadequate communication between health facilities were the major challenges to the referral process. Suggestions for improving referrals were hinged on procedures to promote caretaker adherence to referral, including reducing waiting time and minimising the expenses incurred by caretakers. We recommend that triage at referral facilities should be improved and that health workers in low-level private health facilities (LLPHFs) should routinely be included in the capacity-building trainings organised by the Ministry of Health (MoH) and in workshops to disseminate health policies and national healthcare guidelines. Further research should be done on the effect of improving communication between LLPHFs and referral health facilities by affordable means, such as telephone, and the impact of community initiatives, such as transport vouchers, on promoting adherence to referral for sick children.
format Online
Article
Text
id pubmed-8618635
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-86186352021-11-27 A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda Mwanga-Amumpaire, Juliet Kalyango, Joan Nakayaga Ndeezi, Grace Rujumba, Joseph Owokuhaisa, Judith Stålsby Lundborg, Cecilia Alfvén, Tobias Obua, Celestino Källander, Karin Children (Basel) Article Over 50% of sick children are treated by private primary-level facilities, but data on patient referral processes from such facilities are limited. We explored the perspectives of healthcare providers and child caretakers on the referral process of children with common childhood infections from private low-level health facilities in Mbarara District. We carried out 43 in-depth interviews with health workers and caretakers of sick children, purposively selected from 30 facilities, until data saturation was achieved. The issues discussed included the process of referral, challenges in referral completion and ways to improve the process. We used thematic analysis, using a combined deductive/inductive approach. The reasons for where and how to refer were shaped by the patients’ clinical characteristics, the caretakers’ ability to pay and health workers’ perceptions. Caretaker non-adherence to referral and inadequate communication between health facilities were the major challenges to the referral process. Suggestions for improving referrals were hinged on procedures to promote caretaker adherence to referral, including reducing waiting time and minimising the expenses incurred by caretakers. We recommend that triage at referral facilities should be improved and that health workers in low-level private health facilities (LLPHFs) should routinely be included in the capacity-building trainings organised by the Ministry of Health (MoH) and in workshops to disseminate health policies and national healthcare guidelines. Further research should be done on the effect of improving communication between LLPHFs and referral health facilities by affordable means, such as telephone, and the impact of community initiatives, such as transport vouchers, on promoting adherence to referral for sick children. MDPI 2021-11-02 /pmc/articles/PMC8618635/ /pubmed/34828709 http://dx.doi.org/10.3390/children8110996 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mwanga-Amumpaire, Juliet
Kalyango, Joan Nakayaga
Ndeezi, Grace
Rujumba, Joseph
Owokuhaisa, Judith
Stålsby Lundborg, Cecilia
Alfvén, Tobias
Obua, Celestino
Källander, Karin
A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title_full A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title_fullStr A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title_full_unstemmed A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title_short A Qualitative Exploration of the Referral Process of Children with Common Infections from Private Low-Level Health Facilities in Western Uganda
title_sort qualitative exploration of the referral process of children with common infections from private low-level health facilities in western uganda
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618635/
https://www.ncbi.nlm.nih.gov/pubmed/34828709
http://dx.doi.org/10.3390/children8110996
work_keys_str_mv AT mwangaamumpairejuliet aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT kalyangojoannakayaga aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT ndeezigrace aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT rujumbajoseph aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT owokuhaisajudith aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT stalsbylundborgcecilia aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT alfventobias aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT obuacelestino aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT kallanderkarin aqualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT mwangaamumpairejuliet qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT kalyangojoannakayaga qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT ndeezigrace qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT rujumbajoseph qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT owokuhaisajudith qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT stalsbylundborgcecilia qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT alfventobias qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT obuacelestino qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda
AT kallanderkarin qualitativeexplorationofthereferralprocessofchildrenwithcommoninfectionsfromprivatelowlevelhealthfacilitiesinwesternuganda