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. 2020 Sep;109(9):1867-1874.
doi: 10.1111/apa.15200. Epub 2020 Feb 17.

Insufficient referral practices of sick children in Ethiopia shown in a cross-sectional survey

Habtamu Beyene  1   2 , Dejene Hailu  2 , Henok Tadele  3 , Lars Åke Persson  4 , Della Berhanu  4
Affiliations

Insufficient referral practices of sick children in Ethiopia shown in a cross-sectional survey

Habtamu Beyene et al. Acta Paediatr. 2020 Sep.

Abstract

Aim: This study aimed at assessing the referral of sick young infants and children from the community, health posts and health centres to higher levels.

Methods: A cross-sectional survey was conducted in four of the largest Ethiopian regions from December 2016 to February 2017. Referral practices were assessed at each level in 46 districts of these regions. Interviews were supplemented by reviews of registers at health posts and health centres.

Results: The women's development group leaders, who do not provide health services, referred half of the sick children they visited in the community to the health posts. The health extension workers referred 16% of the sick young infants and 6% of older infants and children to higher levels. From health centres, the health workers referred 6% of sick young infants and 1% of older infants and children to hospital. Many cases of possible severe bacterial infection were not referred to higher levels. A functional ambulance was available for a bit more than a third of the health centres.

Conclusion: Referral practices of sick young infants and children at all levels were weak that may threaten the continued reduction of child mortality in Ethiopia. Referral logistics were insufficient, which partly could explain the missing referrals of severely ill infants and children.

Keywords: health extension workers; logistics; primary health care; referral; sick child.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Ethiopian referral pathways from primary to tertiary levels. HEW, health extension workers; HW, health workers; WDG, women's development group leaders
See this image and copyright information in PMC

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