ArticleJournal of public health in Africa2025
Community referral system influencing caregiver health-seeking for childhood pneumonia in Endebess sub-county, Kenya.
Article in Journal of public health in Africa, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pneumonia is the primary infectious cause of mortality in children under five, with approximately 800 000 deaths annually in low-income settings. In Kenya, pneumonia accounted for 16% of child deaths in 2022. Good treatment outcome relies on efficient referral system and timely hospital access. However, monitoring referral completion remained challenging in Endebess hospitals. Aim: To assess determinants and key barriers to utilisation of community referral system. Setting: Seven public hospitals in Endebess sub-County in Kenya. Methods: This mixed-methods study involved 273 caregivers, 24 health personnel, 40 Community Health Volunteers (CHV's) and 4 Community Health Assistants. Data were collected using questionnaires and interviews. Quantitative analysis used Statistical Package for Social Sciences Version 22 (Chi-square, logistic regression; Results: Overall, 112 caregivers (41%) were referred. However, only 19 referral forms (17%) were filed at hospitals and 10 children (52.6%) recorded in service delivery logbook. Referral completion was significantly associated with distance to the hospital ( Conclusion: Utilising CHV diaries and household registers improves referral completion, highlighting the need for digital integration to strengthen data concordance. Contribution: This study informed policymakers on strengthening community referrals by emphasising CHV report verification, mentorship on documentation and ensuring referral completion.
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