Coping with paediatric referral--Ugandan parents' experience

Area of Science:

• Pediatrics
• Public Health
• Health Systems Research

Background:

• The Integrated Management of Childhood Illness (IMCI) strategy relies on timely referral of severely ill children to hospitals.
• Effective referral completion is essential for reducing child mortality in resource-limited settings.

Purpose of the Study:

• To assess the completion rate and associated costs of hospital referrals for severely ill children in rural Uganda.
• To identify barriers preventing caretakers from completing hospital referrals.

Main Methods:

• A study was conducted across 12 health facilities in rural Uganda.
• The referral completion status of 227 children was tracked over two weeks.
• Data on referral costs and reasons for non-completion were collected.

Main Results:

• Only 28% of referred children completed hospital referral within two weeks.
• The median referral cost was 8.85 USD, with significant variability.
• Primary barriers included lack of funds (90%), transport issues (26%), and home responsibilities (17%).

Conclusions:

• The high cost of paediatric referral in rural Uganda hinders its effectiveness.
• Reducing referral costs and refining IMCI criteria are necessary for realistic paediatric care.
• Empowering first-level health workers to manage severe childhood illnesses is recommended.