Evaluation of the Implementation of a Referral System in the Community Health Center of Abeli, Kendari, Indonesia

Abstract

Background: The referral rate in Southeast Sulawesi in the first-level health facilities was still high, which reached 17% in 2016. Ideally, the maximum referral rate in the first-level facilities should be no more 5%. Objective: This study aims to evaluate the implementation of the first-level referral system in terms of availability of health personnel, facilities and medicines, and understanding of health officers on the referral system at the Community Health Center of Abeli.Methods: In-depth interviews were conducted with a total of 5 health facility managers. All the materials were analyzed using a qualitative thematic analysis approach.Results: Three themes emerged from data; namely human resources (Lack of responsibility of midwives, Lack of communication between staffs, Lack of the number of physician, Understanding of health personnel regarding referral system), availability of facilities, and availability of drugs.Conclusion: Availability of human resources, facilities and drugs is unreliable. Effort should be made to ensure the quality of service provided. This should imply, amongst other things, that human resources, drugs and facilities are adequately available and accessible.

The Challenges of Implementing a Health Referral System in South Africa: A Qualitative Study

“…Our findings are consistent with other previous studies reporting inadequate supply of medicines or drugs affecting referrals, 12 , 13 and the subsequent action of patients in an effort to acquire better health services, particularly in developing countries, by-passing the primary level of care to a higher level. 34 The lack of drugs at healthcare facilities might impair equitable distribution, patient health, and referrals pathways. 13 Our study also identified improper patient flow as a barrier to the establishment of a referral system.…”