1. REFERRAL
George Chaipa Lungu

2. 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

3. 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.

4. 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.

5. 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

6. 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

7. 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

8. 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

9. 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.

10. 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

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

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

13. 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

14. 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.

15. 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

16. 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

17. 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!

18. THANK YOU FOR LISTENING
SIYABONGA KAKHULU