Strategies to strengthen referral from primary care to secondary care in low- and middle-income countries
Overview
Primary care is seen as the main way for achieving UHC in many countries. Creating an essential package of services and bringing those services nearer to users is essential to improve coverage. However, just as important are availability of hospital services and integration of the hospital and primary care.
This policy brief and the accompanying background paper identifies the current challenges that many low- and middle-income countries are grappling with when it comes to delineating services that patients should use at primary or secondary care level and using published documents identifies three strategies that contribute to better management of referrals:
- introduce/enhance gatekeeping role of primary care providers;
- define clearly package of services that are provided in each level; and
- link financing and provider payment mechanisms for each level.
The above strategies work best when they are out in place together as a package rather than individually.
The brief concludes by identifying an approach to introduce these strategies within the health architecture