PIVOT Works | Evaluation Of Referral Team And Ambulance Network Reveals Marked Progress

05 Aug 2016 Evaluation Of Referral Team And Ambulance Network Reveals Marked Progress

by Pivot

Approximately 18 months ago, PIVOT launched an ambitious initiative: an ambulance network in a district where ambulance service had never existed, coupled with new patient referral protocol to help direct patients as necessary to higher levels of care. The service has been managed since its start by a dedicated team of nurses and ambulance drivers who are based at the DistrictHospital (CHRD), and are on-call and available for patient transfers 24/7.

We at PIVOT place an enormous emphasis on quality data collection so that we can measure the impact of our work. Our Monitoring and Evaluation (M&E) team collects and tracks a wide variety of data, from the number of children we successfully treat for malnutrition to how often women choose to give birth in one of our health centers. This year, the M&E team did a formal evaluation to assess the progress of the Referral Program and the impact it has had in the district since its start. The evaluation included both quantitative and qualitative components and involved representatives from all levels of care across the referral chain – from community health workers to doctors in tertiary hospitals.

Some of the major findings of the evaluation:

Health facilities have increased referral rates.
The referral network of the district has grown; health centers located furthest from the CHRD are now referring patients; when necessary, more complex cases are being sent to tertiary health facilities outside the district.
Health facilities have improved communication, making referrals more timely and efficient.
There have been major improvements in partnership and coordination; health actors along the referral chain acknowledge their shared primary objective of improving the continuum of care.

Also included in the evaluation were first-hand accounts of the referral program’s success from patients whose care included a referral and ambulance transport:

Emilien, 26, was referred from a health center to the district hospital. “The ambulance came to get me and took me to the hospital. I was not scared of the ambulance, I was only scared for my health,” he says. Emilien was hospitalized for 4 days and was treated for typhoid fever and severe malaria. “I was scared to die, as I do not have children yet. When I left the hospital, I was feeling healthy.” Today, Emilien is in good health.

Edgard, 60, was referred to the university hospital due to complications related to his diabetes. He was referred, hospitalized for 4 days and has had many follow up visits. “Without PIVOT, I would have never been able to afford all this medicine and keep up with my follow-up visits,” Edgard shared. Edgard felt accompanied and respected, stating that “the PIVOT team was welcoming, cooperative and caring.” Edgard hopes that the health system continues to improve so that more people realize that they do not have to be scared of the doctors, which is a common social barrier to health care in Ifanadiana District.

Many thanks and congratulations to our referral team, whose hard work and dedication have created greater opportunities for residents of Ifanadiana District to access quality health facilities and care.