Referral of sick children and levels of adherence by carers: implications on quality health care in the middle belt of Ghana

Introduction: Severely sick-children presenting at primary healthcare facilities need referral to higher level for better care. Adherence referrals and quality of care received by those referred could serve as critical steps towards their survival.Objective: To describe experiences with severely sick children higher-level health reasons non-adherence referral; explore provider’s perspectives referral.Methods: Referrals among 3046 young were followed adherence. Assessment from a PHC facility adhering advice was determined. Agreement on reported diagnoses centres health-facilities receiving patients assessed. Perspectives providers assessed.Results: 212 various hospitals 14.2% non-adherence. Reasons given: 48.3% carers felt child’s condition severe; 43.3% complied provider directive. The main no money transport (50%) child not serious (30.0%). 69.0% anaemia cases diagnosed hospitals. 65.7% fever confirmed malaria the Healthcare severity, perceivedcomplication non-response treatment.Conclusion: generally good. agreement in diagnosis common diseases such district high low rarer diseases. Capacity should be provided levels adequate management presented reduce have make