REFERRAL George Chaipa Lungu

OBJECTIVES Describe a referral Describe the services in the referral network Describe benefits of a referral network Demonstrate understanding of the referral framework Explain the steps in making referrals within the project activities

What is referral? A referral is made when a service provider (health care or social service worker like peer educator) guides a client to obtain services that will meet the client’s need for continuity of care Referral is the process by which immediate client needs for comprehensive SRH supportive services are assessed and prioritized with client, service options are discussed and clients are helped to gain access to needed services.

REFERRAL PROCESS Client/Patient: person who is accessing HIV/AIDS services Referring organization: organization that first makes the referral; it is also sometimes called the coordinating organization. Receiving organization: the organization to which the client is referred for services; it is also sometimes called the organization that fulfilled the referral.

SRH REFERRAL SERVICES HIV/AIDS Treatment (ART/ARV) Family Planning Gender based violence support HTC Home based care Livelihoods Support OVC Services & support Nutrition & food supplements PTC & psychosocial Social welfare PEP services PMTCT STI services TB screening & treatment Medical care Free condom distribution Prevention

BENEFITS OF REFERRAL OF REFERRAL NETWORK Comprehensive services and access to continuum of care for clients It promotes continuity of care and support Coordinated and improved service provision Service provision is expedited Helps to have feedback loop Confidentiality is maintained across network members as a core value Referrals can be tracked and documented Gaps in services can be identified and addressed Referrals help people to know where they can be assisted It simplifies the fight against HIV/AIDS because people work as a team It strengthens partnerships Quality of life: enhancing the health and well-being of PLHIV Decreases stigma and discrimination Increases emotional and social well-being Better adherence to ART Reduced costs of service delivery coupled with improved outcome

Barriers to Forming Referral Networks Underrating each other among service providers Poor coordination among service providers Geographical locations Ignorance on the importance of the coordinating in the fight against HIV/AIDS Jealousy among service providers

Referral Frame Work for Continuum of Care Psychosocial support provided by CBOs CBO CBO CBO CBO Provides: ART- services PMTCT services FP services Post abortal care HTC services PEP services Undertakes: Screening of GBV survivors Branding: With approval from MoH/DHO Legal Service ‘Hub’ Health facility Police VSU Peer educator Peer educator Peer educator Peer educator COMMUNITY LEVEL Community-Level GBV sensitization including youth club, TAs, VHM, etc

Managing the referral process Each peer educator should have a supply of the Tovwirane developed REFERRAL FORM – especially the General Referral Forms General Referral Register Provider Service Directory N.B: Use every opportunity (in addition to the routine IPC sessions )to screen the MARPs client to refer for HTC, PMTCT, PEP, FP, PEP, STI, TB and other HIV related services. Use one referral form for each place where you are sending the client by completing applicable section of the form, refers client to services based on client’s concerns.

Peer educators referral ‘HUB’ Health facility Receives client Requests referral form and fills out part B of form Places referral form brought by client in referral box Registers client in Receiving Referral Register (RRR) Provides service If needed, refers client to various appropriate health services Peer educator referral Refers client to hub’s services based on client’s concerns Fills out general referral form and general referral register Files duplicate of referral form for later back-referral verification Compiles data of referrals by the end of the month Provides referral data

Service options discussed Referral Framework Help to gain access Service options discussed Client needs assessed 4. How? 3. When & Where? 2. What? Create trust

Referral framework and steps to make referral Establish rapport Needs assessment Provide referral Help to gain access

Step 1: Developing Trust - Starts with larger process/context - Uphold the following principles/values Confidentiality Respect for client’s privacy and right to say “no” Avoid stigma and discrimination Be thorough and provide client clear/accurate information Do not take advantage of situation for personal gain Be professional at all times

Step 2: Assessment of Client Needs Explain areas where client might need services, taking into consideration services available in your area Discuss client’s major concerns in terms of services needed If there is concern about a friend/family member do not make formal referral but give some suggestions. It is best if family member/friend meets the counselor. Do you understand your personal risks of HIV infection and transmission? Do you know where to go? Have you had an HIV Test before? How long ago? If you have a partner/spouse, can you go together? Are there any other health or well being issues for which you might need services? If so, I might be able to help you to determine where to go.

Step 3: Discuss Option Where: at the hub facility Outline the health and social service options available in the area to address client needs Help the client to access services at the hub facility and explain the importance of accessing those services When: Priorities – Prioritize needs

Step 4: Help to Gain Access Explain the importance of the services Identify sources of support (family, friends) that can help the client access the services Discuss which factors may make it difficult for the client to access the service(e.g., location, lack of transportation or child care, work schedule, cost, stigma) and try to address them based on available resources Provide client referral form and fill out referral register

Key Point – remember Do not be pushy Do not pass judgment Confidentiality is crucial Do not talk as if you are superior Be courteous and respectful Maintain professional lines Walk the talk!

THANK YOU FOR LISTENING SIYABONGA KAKHULU