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The Journal of Community Health Management


Challenges and response to the practices in paediatric referral based on a Case Study from C.G.H.S. Dispensaries in Jaipur, Rajasthan


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Author Details: Monisha Sahai

Volume : 4

Issue : 1

Online ISSN : 2394-2738

Print ISSN : 2394-272X

Article First Page : 11

Article End Page : 17


Abstract

Background: A strong referral chain is vital for the proper functioning of any broad base community health care pyramid. Improper referral contributes to high childhood morbidity and mortality. Since this referral chain is as strong as its weakest link, identifying and strengthening the weak links will help provide efficient, effective, affordable and equitable health care to the community. Inadequate evaluation of paediatric patients by the referring physician in the peripheral CGHS(Central government Health Scheme) dispensaries was resulting in a high patient load at the referral hospital where the author was working as a specialist, and frustration in the patient’s caregiver. The associated delay in receiving specialist's care often resulted in aggravation of the basic disease.
Material and Methods: In a study conducted in a referral Urban health care system in India (CGHS), primary data collected from 264 referred patients and secondary data of 5 referring peripheral clinics was analysed.
Results: Reasons for improper paediatric referral and common conditions requiring referral and specialist's care were identified.
Conclusions: Identified lacunae in referral were corrected using a unique "WISH" format, devised by the author. This helped the primary care physician in doing a quicker ,comprehensive and easily reproducible health check-up and rapid referral of the paediatric patient, if required, to a higher centre. This tool will empower the primary care physician in improving patient evaluation at the first link of a referral health care system and ensure early, economic and efficient referral.

Keywords:
Paediatric Referral Status in India, Mortality, Morbidity, Referral Protocol of Paediatric Patients