Intra-Facility Referrals in Plateau State Improve Access to Primary Health Care Services

Esther Daniel in the family planning unit at PHC Bukuru.

In Nigeria, strengthening intra-facility referrals was identified as an easy way to ensure that there are no missed opportunities for offering patients family planning counseling and services within health facilities. With intra-facility referrals, patients who come for other services are often directed to the family planning unit to access counseling and services. These intra-facility referrals not only improve uptake of family planning services but also promote the uptake of other primary health care services.

In Plateau state, Esther Daniel, a 40-year-old mother of six children including a newborn, was referred to the family planning unit to access services after she visited a facility supported by The Challenge Initiative (TCI), the PHC Bukuru, in Jos South local government area (LGA) to get her youngest child immunized. At the immunization unit, she was introduced to the benefits of family planning and referred for counseling and possible service uptake.

At the family planning unit, the provider counseled her and she opted for an implant. During the screening for the method and history taking, the provider observed that Esther’s blood pressure was high. Prior to the screening, Esther was unaware of this. A doctor was immediately brought in to see her and, after some examination, she was diagnosed with hypertension.

Esther said:

Most times I feel some discomfort, but I have ignored it. My coming to the facility today for immunizations [for my baby] has led me to access FP and medical care. I now know that I need regular follow-up to prevent hypertension complications. This is new and very good. I hope the PHC staff continue this way.”

This story exemplifies the effectiveness of strengthening intra-facility referrals and integration, which was not happening before TCI’s engagement. As a result of TCI’s coaching support, the LGA Reproductive Health Coordinator oriented this facility and all others within her LGA on intra- and inter-facility integration. PHC Bukuru now embraces integration as a one-stop approach for improving the utilization of all PHC services by clients.

In addition, Esther said she is very happy with the method she chose and wishes other women would access the services and benefit from all PHC services without having to make multiple visits.