Learning from the Experience of a Referral Network in Rural Tanzania

 | Tanzania  | Samuel Mayinoti

Background

The Livelihoods and Food Security Technical Assistance II (LIFT II) project focuses on extending the continuum of care and support for clients accessing HIV and nutrition services by linking them to economic strengthening, livelihood, and food security services to improve overall outcomes. The Mbeya Referral Network (MRN) in rural Tanzania was launched in February 2016 to create the link between health facilities and community-based services for clients in Mbeya Region and currently has 26 members.

Lift II Staff Meet with Stakeholders in Mbeya Tanzania to discuss the lesson learned on the referral network created for the locality

Lift II Staff Meet with Stakeholders in Mbeya Tanzania to discuss the lesson learned on the referral network created for the locality

Problem Faced

Implementation of a multi-sectoral referral network is challenging because many of the stakeholders did not regularly interact prior to the establishment of the network. Because of this, the MRN was faced with the problem of poor communication and coordination among its stakeholders. The communication gaps were leading to uninformed referrals being made because of a lack understanding of services available from service providers in different sectors.
Actions Taken

In order to realize the full potential of the referral network, it was critical to create regular opportunities for interaction and learning among MRN members. The first step was to bring network stakeholders together in a while the MRN was being created. The objective of this meeting was to assemble the diverse set of service providers and relevant government representatives to kick-start the referral system by jointly developing referral priorities and a unified referral network action plan. After the MRN was formally launched, began to bring stakeholders together on a regular and ongoing basis.

MRN members were also encouraged to nominate referral focal persons within their organizations and health facilities to streamline referral-related exchanges between stakeholders who often have complex organizational structures. Finally, a Service Provider Directory was created and provided to each MRN member. It includes each member’s services offered and contact information. The directory further facilitates communication between fellow MRN members.

Results

The initial stakeholder meeting was attended by 20 organizations and resulted in the referral network action plan for MRN. Enthusiasm and interest in the potential impact of the referral network was generated and created a strong foundation for launching the referral network. Monthly MRN review meetings have been held since May 2016 with an average of 37 participants in attendance. These meetings provide a critical platform for fruitful discussions regarding referral challenges and developing shared solutions from a diverse input of ideas. MRN members have stated that the meetings allow them to get to know other service providers and their services to make more informed referrals. The Service Provider Directory allows MRN members who may not have met in person to make contact with one another during the referral process and to discuss referral issues.

Lessons Learned

Regular interaction and communication among government, health facility and community-based stakeholders is essential to the establishment and long-term viability of referral networks in Mbeya and elsewhere. By fostering a collective network identity, the foundation is laid for continued communication and ongoing collaborative problem solving among network members which is needed to reach the common goal of holistically addressing the needs of referral clients.

Key Points

LIFT II works across multiple sectors to establish bi-directional clinic-to-community referral network

The vitality of the referral networks depends on strong communication and coordination among service provider

Mbeya Referral Network in rural Tanzania utilizes stakeholder meetings regular monthly referral network member meetings to facilitate coordination and ongoing strengthening of network member relationships to increase the quality of referrals and client outcomes