Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria

IntroductionThe inadequate referral system in Nigeria is partly due to the proliferation of informal healthcare providers (IHPs) and constraints within formal providers in urban slums. With limited data on patient referral experiences across these providers, this paper explores referral experiences...

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Main Authors: Chinelo Obi, Ifeyinwa Arize, Chukwudi Nwokolo, Benard Okechi, Bassey Ebenso, Obinna Onwujekwe
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561158/full
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author Chinelo Obi
Chinelo Obi
Ifeyinwa Arize
Ifeyinwa Arize
Chukwudi Nwokolo
Chukwudi Nwokolo
Benard Okechi
Benard Okechi
Bassey Ebenso
Obinna Onwujekwe
Obinna Onwujekwe
author_facet Chinelo Obi
Chinelo Obi
Ifeyinwa Arize
Ifeyinwa Arize
Chukwudi Nwokolo
Chukwudi Nwokolo
Benard Okechi
Benard Okechi
Bassey Ebenso
Obinna Onwujekwe
Obinna Onwujekwe
author_sort Chinelo Obi
collection DOAJ
description IntroductionThe inadequate referral system in Nigeria is partly due to the proliferation of informal healthcare providers (IHPs) and constraints within formal providers in urban slums. With limited data on patient referral experiences across these providers, this paper explores referral experiences in urban slums in southeast Nigeria.MethodsThis study involved 1,025 people in eight slums in Enugu and Anambra states, using multi-stage purposive sampling. Data on referral experiences were collected through a pre-tested questionnaire and analyzed using descriptive statistics and logistic regression. Ethical approval was obtained, and informed consent was secured.ResultsIt found that only 7.4% of patients received referrals from their primary healthcare sources, mostly from patent medicine vendors, private clinics, and primary healthcare (PHC) centres to private clinics and laboratories. Verbal referrals were the dominant modality, although the types of referrals varied significantly between facilities that initiated referrals and between states.ConclusionThis paper highlights the need for innovative solutions to integrate informal healthcare providers into the formal system, improving referrals and enhancing health services in urban slums.
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publisher Frontiers Media S.A.
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spelling doaj-art-03322a739f0b40eda7ccdcae1c1e7bd12025-08-20T03:12:31ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15611581561158Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast NigeriaChinelo Obi0Chinelo Obi1Ifeyinwa Arize2Ifeyinwa Arize3Chukwudi Nwokolo4Chukwudi Nwokolo5Benard Okechi6Benard Okechi7Bassey Ebenso8Obinna Onwujekwe9Obinna Onwujekwe10Health Policy Research Group, University of Nigeria, Enugu, NigeriaDepartment of Health Administration and Management, University of Nigeria, Enugu, NigeriaHealth Policy Research Group, University of Nigeria, Enugu, NigeriaDepartment of Health Administration and Management, University of Nigeria, Enugu, NigeriaHealth Policy Research Group, University of Nigeria, Enugu, NigeriaCentre for Entrepreneurship and Development Research, University of Nigeria, Enugu, NigeriaHealth Policy Research Group, University of Nigeria, Enugu, NigeriaDepartment of Psychology, University of Nigeria, Enugu, NigeriaLeeds Institute of Health Sciences, University of Leeds, Leeds, United KingdomHealth Policy Research Group, University of Nigeria, Enugu, NigeriaDepartment of Health Administration and Management, University of Nigeria, Enugu, NigeriaIntroductionThe inadequate referral system in Nigeria is partly due to the proliferation of informal healthcare providers (IHPs) and constraints within formal providers in urban slums. With limited data on patient referral experiences across these providers, this paper explores referral experiences in urban slums in southeast Nigeria.MethodsThis study involved 1,025 people in eight slums in Enugu and Anambra states, using multi-stage purposive sampling. Data on referral experiences were collected through a pre-tested questionnaire and analyzed using descriptive statistics and logistic regression. Ethical approval was obtained, and informed consent was secured.ResultsIt found that only 7.4% of patients received referrals from their primary healthcare sources, mostly from patent medicine vendors, private clinics, and primary healthcare (PHC) centres to private clinics and laboratories. Verbal referrals were the dominant modality, although the types of referrals varied significantly between facilities that initiated referrals and between states.ConclusionThis paper highlights the need for innovative solutions to integrate informal healthcare providers into the formal system, improving referrals and enhancing health services in urban slums.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561158/fullhealthcare systemhealthcare consumershealthcare providersreferralurban slumsinformal health providers
spellingShingle Chinelo Obi
Chinelo Obi
Ifeyinwa Arize
Ifeyinwa Arize
Chukwudi Nwokolo
Chukwudi Nwokolo
Benard Okechi
Benard Okechi
Bassey Ebenso
Obinna Onwujekwe
Obinna Onwujekwe
Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
Frontiers in Public Health
healthcare system
healthcare consumers
healthcare providers
referral
urban slums
informal health providers
title Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
title_full Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
title_fullStr Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
title_full_unstemmed Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
title_short Referral experiences of healthcare consumers: results from a cross-sectional study in urban slums in southeast Nigeria
title_sort referral experiences of healthcare consumers results from a cross sectional study in urban slums in southeast nigeria
topic healthcare system
healthcare consumers
healthcare providers
referral
urban slums
informal health providers
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561158/full
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