Habib Ahmed Afsar, Muhammad Younus, Asma Gul.
Outcome of patient referral made by the Lady Health Workers in Karachi, Pakistan.
J Pak Med Assoc Jan ;55(5):209-11.

The outcome and consequences of referral made by the Lady Health Workers (LHWs) are largely unknown. This cross sectional study was conducted as part of a larger study and aims to assess outcome of patients` referrals made by the LHWs in Karachi, Pakistan. Only 4% of patients referred visited government facilities, the rest having visited private physicians and in-formal practitioners. The median cost of the treatment was 200 Pakistani Rupees (PKR) and 1230 PKR as out -patient and in-patient respectively with almost half the patients (41.3%) borrowed money to finance their treatment. Seventy-eight (31.6%) patients were not satisfied with the management they received from the referral health facilities. Major reasons cited were nonimprovement in their condition, expensive, long waiting time and rudeness of the health facility staff. Factors identified in this study should be taken into account to ensure continuity and quality of care and to provide efficient, effective and equitable health services to all.

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