Assessing the challenges in the referral system: a case study in the Hohoe Municipality

Background: An effective referral system ensures a patient receives optimal health care at an appropriate health care level, specifically in times of medical emergency.A well-functioning referral system should allow the continuity of health care across the different tiers of care.Contrary, Ghana's health care referral system has not been given the needed attention despite the significant role an effective referral system can play in saving the lives of patients.This study explored the challenges of the referral system in the Hohoe municipality.Methods: This study used a phenomenological qualitative research approach.Health workers and relatives of patients who have been through the referral system were recruited for the study.In-depth interviews were conducted using an open-ended interview guide.The interviews were tape-recorded with permission from the participants who had been through the referral system and health workers in the Hohoe municipality.Thematic analysis was used to analyze the data.Qualitative software package Atlas.ti was used in generating codes and themes. Results:The results of the study show that inadequate human resources like medical experts and infrastructures like the unavailability of enough beds and medical supplies, were some of the challenges faced by the health workers.Socio-economic factors like not being able to afford the means to get to the next facility, also bad roads, unavailability of some medical supplies like oxygen were not readily available, bad attitude, and reluctance from some health workers were some of the challenges encountered by the relatives who have been through the referral system.Conclusion: Referral is very important in the continuity of care and if the challenges are not being looked at more lives would be lost.Road networks, human infrastructures, and medical supplies are needed for the smooth running of the referral system.