ArticleBMJ open2021
Factors associated with the referral of children with severe illnesses at primary care level in Ethiopia: a cross-sectional study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Missed opportunities for hospital referral of young children with severe pneumonia identified at primary care using pulse oximetry: an analysis from the AIRE study in West Africa.BMJ global health · 2025Article
- Care management and determinants of day 14 mortality in severely ill children aged under 5 years subsequent to hypoxaemia diagnosed using routine pulse oximetry in primary care: evidence from the AIRE project.BMJ global health · 2025Article
- Article
- A systematic scoping review of medicine availability and affordability in Africa.BMC health services research · 2024Article
- Estimated travel time and staffing constraints to accessing the Ethiopian health care system: A two-step floating catchment area analysis.Journal of global health · 2023Article
- Predictors of referral behaviour and intention amongst physicians in a medical consortium based on the theory of planned behaviour: a cross-sectional study in China.Frontiers in public health · 2023Article
- Assessing Facilitators and Barriers to Referral of Children Under the Age of Five Years at Ndirande Health Centre in Blantyre, Malawi.Global pediatric health · 2021Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
CONTEXT AND
objectiveEthiopia's primary care has a weak referral system for sick children. We aimed to identify health post and child factors associated with referrals of sick children 0-59 months of age and evaluate the healthcare providers' adherence to referral guidelines.
designA cross-sectional facility-based survey.
settingThis study included data from 165 health posts in 52 districts in four Ethiopian regions collected from December 2018 to February 2019. The data included interviews with health extension workers, assessment of health post preparedness, recording of global positioning system (GPS)-coordinates of the health post and the referral health centre, and reviewing registers of sick children treated during the last 3 months at the health posts. We analysed the association between the sick child's characteristics, health post preparedness and distance to the health centre with referral of sick children by multivariable logistic regressions. OUTCOME MEASURE: Referral to the nearest health centre of sick young infants aged 0-59 days and sick children 2-59 months.
resultsThe health extension workers referred 39/229 (17%) of the sick young infants and 78/1123 (7%) of the older children to the next level of care. Only 18 (37%) sick young infants and 22 (50%) 2-59 months children that deserved urgent referral according to guidelines were referred. The leading causes of referral were possible serious bacterial infection and pneumonia. Those being classified as a severe disease were referred more frequently. The availability of basic amenities (adjusted OR, AOR=0.38, 95% CI 0.15 to 0.96), amoxicillin (AOR=0.41, 95% CI 0.19 to 0.88) and rapid diagnostic test (AOR=0.18, 95% CI 0.07 to 0.46) were associated with less referral in the older age group.
conclusionFew children with severe illness were referred from health posts to health centres. Improving the health posts' medicine and diagnostic supplies may enhance adherence to referral guidelines and ultimately reduce child mortality.
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