Assessing the Effectiveness Of Referral Services

Provided By Community Health Promoters In Nairobi

County

Presented by:
6th June, 2024.
 Introduction/Background
• Community Health Promoters (CHPs) play a critical role in
improving health outcomes by providing essential referral
services in Nairobi County. The MOH recognizes CHPs role in
screening and proper identification of danger signs. Their role
is to refer community members who need professional health
services in good time. Prompt referral often can save the life of
and prevent from worsening the situation. Despite their
importance, there is limited research on the effectiveness of
these referral services. This study will help in understanding
the effectiveness of these referral services and the challenges
faced by CHPs in linking families to hospitals. The research
will address that gap that is has been identified as a less than
optimal referral system. This concept builds upon results from a
Baseline Study on the Functionality of the Health Referral
System in Eight Counties across the country.
 Elements of a Functional Referral System

• Referral strategy informed by assessments of

population needs and health system capabilities.
• Adequately resourced referral facilities
• .Active collaboration between referral levels and
across sectors.
• Setting-specific protocols for referring and
receiving facilities
• .Accountability and supportive supervision
• .Formalized communication and transport
arrangements.
• protection against emergency referral costs
Photo by Wes Dissy on Unsplash
• .Government support through health policy.
 Statement of the problem

•Referral systems manage client health needs with

resources beyond local availability.

•Only 15% of community units had guidelines for the

referral process.

•The Kenya Health Policy 2012–2030 emphasizes

strengthening the referral system for better efficiency
and outcomes. Photo by Cytonn Photography on Unsplash
 Research Objectives

• To determine the influence of CHPs' training and

knowledge on the effectiveness of referral services
in Nairobi County.
• To assess the impact of resource availability (e.g.,
transport, communication tools) on the successful
implementation of referral services by CHPs.
• To identify and analyze the barriers faced by
CHPs in the referral process,.
• To evaluate the effectiveness of existing referral
tracking and feedback mechanisms used by CHPs
in ensuring successful follow-ups.
Photo by Rémy Venturini on Unsplash
 Research Questions
• How do organizational factors such as training adequacy
and resource availability impact the effectiveness of
referral services provided by CHPs in Nairobi County?
• In what ways do community perceptions and trust
influence the utilization of referral services provided by
CHPs in Nairobi County?
• How do socio-economic factors of the target population
(e.g., income levels, education) affect their access to and
utilization of referral services facilitated by CHPs in
Nairobi County?
• What strategies can be recommended to improve the
integration and coordination of referral services between
Photo by Cytonn Photography on Unsplash
CHPs and formal healthcare facilities in Nairobi
County?
 Research Methods

• This research intends to use qualitative methods to

explore the challenges and facilitators of referral
services by Community Health Promoters (CHPs)
in Nairobi County.
• In-depth interviews with 100 CHPs and focus
group discussions with 10-15 community
members.
• Interviews and discussions will be audio-recorded,
transcribed, and analyzed using thematic analysis.
• Ethical considerations: informed consent,
participant confidentiality, and ethical approval.
Photo by Patrick Otim on Unsplash
 Limitations

• Potential participant bias and subjective

nature of qualitative data

• Steps will be taken to mitigate these

through rigorous data collection and
analysis techniques.

Photo by Cytonn Photography on Unsplash

 Likely Outcomes/Benefits/Dissemination

• Key insights into referral process challenges and

facilitators.
• Actionable recommendations for improving
healthcare delivery through enhanced referral
services
• .Benefits for policymakers, healthcare providers,
CHPs, and community members
• .Potential adoption of a functional referral system
across CUs in Nairobi County. Photo by Cytonn Photography on Unsplash
 Research Timeline
Research Section Duration

Title 1 week

Introduction 1 week

Need for this Study 1 weeks

Background 2 weeks

Objectives 1 week

Research Questions and/or Hypothesis 1 week

Research Methods 2 weeks

Data Analysis, Interpretations, Discussions 3 weeks

Summary, Conclusion, and Recommendations 1 week

Reviewing Work for Final Submission 1 week

 Conclusion

• In conclusion, this study suggests that the

health referral system in Kenya is less than
optimal and the system needs immediate
strengthening.
• Strengthening the health referral system can
be accomplished only through comprehensive
interventions that will affect all elements of
the referral system.
• County-level recommendations include:
adequately resourcing health facilities to meet Photo by Wes Dissy on Unsplash

national standards by increasing staff,

improving infrastructure, and ensuring
medicine availability.
References

• Key Sources: Mugambi, K., Nyaberi, J., & Echoka, E. (2024).

Assessment of barriers and challenges to the screening and
linkages of Non-Communicable Diseases by Community health
volunteers in Nyeri County, Kenya. Global Journal of Health
Sciences, 9(1), 34–47. https://doi.org/10.47604/gjhs.2545
• Other Sources: Ministry of Health Kenya. (2013). Sessional
Paper No. 6 of 2012 of the Kenya Health Policy 2012–2030
(Draft)..
• Murray, S. F., Davies, S., Phiri, R. K., Ahmed, Y. (2001). Tools
for monitoring the effectiveness of district maternity referral
systems. Health Policy Plan, 16, 353–61.
Photo by Enayet Raheem on Unsplash
• Ricca, J. G., Negroustoueva, S. (2009). Development of a
monitoring framework for referral within a network of HIV/AIDs
service providers. Condensed final report based on four case
studies.