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J Prim Care Community Health. 2010 Oct 1;1(3):213-7. doi: 10.1177/2150131910380238.

Intervention to reduce parental bypass of community pediatric primary health facilities in asmara, eritrea.

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  • 1Department of Pediatrics, UC Davis Medical Center, University of California, Davis, Sacramento, CA, USA.

Abstract

OBJECTIVE:

To reduce direct parental referral of low acuity ill pediatric patients to the outpatient facilities of a nation's only pediatric referral hospital.

PATIENTS AND METHODS:

Longitudinal monitoring of outpatient visits at Orotta Children's Hospital (OCH) and primary health facilities (PHFs) following implementation of an intervention designed in response to information provided by parents and health-care providers. Parental surveys were undertaken before and after exposure to the intervention to assess effects on knowledge, attitudes, and behavioral intentions.

RESULTS:

We analyzed 5,639 visits between baseline and follow-up, documenting a decline in parental referral among OCH outpatients from 95% to approximately 80%. Educational intervention increased the proportion of parents intending to use PHF for future outpatient care from 28% to 82%. Staff of the PHFs responded enthusiastically to this intervention program and requested further activities.

CONCLUSIONS:

Self-referral to tertiary care hospital was reduced following a modest program of parental education designed and implemented by residents in training.

KEYWORDS:

community health; developing nation; health services accessibility; pediatric; primary care

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