Referral Paper Completeness And Its Barriers Among Patients Referred To Obstetrics And Gynecology Units Of Public Hospitals In West Shoa Zone; Oromia, Ethiopia, 2021

Abstract

Background: Referral is the act of transferring clients for consultation, further action or to direct someone to a source of help. Referrals made by primary physicians have significant impact on the quality and the cost of health care. Even, previous studies have conducted to improve the quality and content of referral paper referred to hospital there is a problem of inadequate communication through referral paper between the referring providers and receiving providers. These study was aims to explore of barriers that cause referral paper incompleteness during the referral process. Objective: The objective of this study was to assess referral paper completeness and its barriers among patients referred to obstetrics and gynecology units of public hospitals in West Shoa zone; Oromia, Ethiopia, 2021. Method: An explanatory sequential mixed method design was conducted. Simple random sampling technique was employed to select five hospitals in west shoa zone. The sample size was proportionally allocated to the selected hospitals. Then systematic random sampling technique was used to enroll 415 referral papers. Checklist was used to collect information from referral papers. The qualitative data was collected through face-to-face interview using open-ended questionnaire from key informants. Quantitative data was entered using EPI INFO and analyzed by using SPSS version 24. Descriptive data is presented with text, percentages, and frequencies. Regarding the qualitative data, the responses were recorded with a mobile and notes were taken manually. Result: In this study, about 57.3%(95%CI:52.5–61.9%) of referral papers were found to be incomplete. The result shows that the name of the patient featured in all of referral paper 415 (100%), while 381(91.9%) of referral paper contain physical examination. In addition, the qualitative study identified six major themes as barriers of referral paper completeness: Time constraints, lack of standard referral paper, absence of feedback from receiving facility, lack of training on referral system, lack of skills and knowledge and reluctances and low motivation of staffs. Conclusion and Recommendation: In this study, significant numbers of referral papers are found to be incomplete and most referrals did not have referral notes. It is strongly recommended that primary health care providers should be trained on how to write referral papers, and providers of higher facilities should write feedback papers to lower facilities