Exact(6)
In this network primary level facilities are supervised by healthcare providers from the referral level.
The Harare Conference of 1987 renewed interest in primary health care and the referral level by proposing the integrated district health system approach [ 18].
The referral level starts at the Health Centre IV, and then hospitals (both district and referral hospitals), which offer curative and surgical services in addition to preventive services (Anokbonggo et al. 2004).
Stratified random sampling methods based on referral level are used for the hospital survey on PHE preparedness because it is found that the preparedness level depends on the referral level [ 14].
For the purposes of clarity, the term 'district' will be used in this paper to refer to the Congolese health zone, that is, a network of primary health care facilities, each of which serves a well-defined part of the district area/population, and a GH, which acts at the referral level for the entire health district area.
Health services are organized around a three tier system at district level, with the district hospital as the referral level, the health centre at subdistrict level, and the Community Health and Planning and Services (CHPS) compounds, which deliver close-to-client services mostly at home, at community level.
Similar(54)
However, the empirical data indicates that health care workers, particularly at the referral levels, complain of being overworked.
Further studies are needed to identify the most important sources of delay in the referral system, as to be able to implement preventive measures and feedback mechanisms across the referral levels.
In such countries, adequate health-care services for managing high-risk pregnancy and delivery are usually available at the referral levels such as regional and national hospitals[ 5, 6].
Finally, interviews with health care providers working at the closest Rural Health Centre (at Mwenzo) and the next referral level, the District Hospital (at Nakonde) were conducted.
UNICEF is currently focusing on improving the services of the Health Centers/ Districts Hospitals as the first referral level in the HUs.
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