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Knowledge, attitude, and perception of the referral system among tertiary health-care workers in Kaduna metropolis, Nigeria

Victoria Nanben Omole, Ahmed Tijjani Mora, Ismaeel Umar Yunusa, Onyemocho Audu, Abubakar Ibrahim Jatau, Abdulrazak Gobir.


Background: Among many recognized factors, the role of health workers remains crucial in influencing the effective running of the referral system. A paucity of information in this area exists in many developing countries.

Objectives: This study sought to probe for such information toward improving the quality of the referral process and the health system at large.

Materials and Methods: Using structured, open-ended, self-administered questionnaires, data were collected from 114 respondents, randomly selected across four tertiary health facilities.

Results: Knowledge and understanding of referral was high (93.8-100%) among respondents. However, attitudes and perceptions expressed regarding diverse aspects of referral such as referral tools, indications for referral, recordkeeping, and practicalities were relatively average. Only 21.9% were aware of standard referral forms; about 20% thought that referral should be at the request of patients. About 65.8% expressed diverse challenges encountered with referrals; and 64.9% support the rejection of certain cases referrals.

Conclusion: The advocacy for reforms in the referral system with regards to the training of health workers; the implementation of referral policies, guidelines and structured, standardized forms is recommended.

Key words: Referral System; Health Workers; Knowledge; Health Systems; Perception

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