Referral System: An Assessment of Primary Health Care Centres in Plateau State, North Central Nigeria

Tolulope O Afolaranmi, Zuwaira I Hassan, Daniel I Filibus, Umaima A Al-Mansur, Lawrence A Lagi, Fwangshak D Kumbak, Jonathan C Daboer, Oluwabunmi O Chirdan

Background: An effective referral system ensures a close relationship between all levels of the health system and helps to ensure patients receive the best possible care close to home. There appears to be a weak link of referral system in chain of continuity of care across the levels of health care in Nigeria placing huge demands on secondary and tertiary levels of care for health care service provision. In view of this, this study was conducted to assess the level of practice of referral and factors influencing it among health workers in PHCs in Plateau state North central Nigeria. Methodology: This was a cross sectional study conducted among 228 frontline health care workers in PHCs. SPSSS version 20 was used for data analysis, adjusted odds ratio as well as 95% confidence interval were used in this study with a p-value of ≤ 0.05 considered statistically significant. Results: The respondents’ mean age was 38.0 ± 9 years with slight above half 116 (54.2%) having good understanding of the concept of referral and most 77.6% had referred at least a case within the last one month. Factors such as good understanding of the concept of referral (AOR = 6.2; 95% Cl = 1.4556 – 8.7991) and availability of referral system (AOR = 8.4; 95% Cl = 2.1168 – 15.5450) were predictors of the practice of referral. Conclusion: This study has demonstrated the level of practice of referral among cadres of health care workers at PHCs level with significant need for improvement.