9.1  Effective referral

Whether or not a sick mother or sick newborn can reach a fully functional health facility in time can literally be the difference between life and death. It helps a great deal if:

• You have taken care to develop and establish strong links with the health facilities that you use (and the health workers in them), so that referrals can be dealt with quickly and efficiently.
• You have mobilised the community to be alert to the need for psychosocial, financial and practical support in cases where critically sick mothers and newborns must reach the health facility urgently.
• You have convinced the mother and family to trust your judgement before the emergency happens, so they are ready to follow your advice if an emergency occurs.
• You are active in following up and checking that the mother and baby get to the health facility. The traditional way of telling the mother or the caregivers to go to the health facility, or just writing a referral note and doing nothing else, is never a sufficient solution.