Moreover women found positive at the outreach programmes are referred for confirmation at a tertiary facility several kilometres away [ 20, 24].
Patient records indicate that more than 50% of women who had a CS at the Mali and Niger sites had been referred for labor care from another facility; most of these women came with no accompanying documentation or partograph.
Only one tertiary care facility in Malawi ever referred for resistance testing and it was to an academic research facility and not in the public sector.
Participants with a positive TST or QFT were investigated for TB disease and referred for treatment at public sector facilities if needed.
We excluded transports from trauma scenes, patients transferred from the HUP to other facilities, patients referred for transfer but not flown, and fixed-wing flights.
The majority of senior health staff are found in urban areas of big cities where patients from rural facilities are referred for expertise management.
16 In 2002 only 5% of paediatric admissions were referred for admission from a primary care facility; the remainer were brought directly to the hospital outpatients department by a parent or caregiver.
These findings demonstrate that when people are opportunistically screened in the community by CHWs and identified as being at a high risk of developing CVD, only a minority (37%) schedule and attend the local health facility after being referred for further evaluation.
In all three sites, TB, ART and coinfected patients who received their treatment in the community or self-administered their treatment, and who were assessed by either the facility staff or LHWs as non-adherent, were referred back for facility-based treatment.
Lastly, establishing partnerships with local hospitals and care providers, when feasible, can ensure that the participant can be referred for additional care, such as specialized facilities for sexual and gender-based violence.
