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

Abstract

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.