title: Reasons for non-uptake of referral: children with disabilities identified through the Key Informant Method in Bangladesh.
abstract: OBJECTIVE
  To identify reasons for the non-uptake of referral for children with disability identified though the Key Informant Method in Bangladesh.
  
  
  METHODS
  Core data was collected and analysed using qualitative methodologies. Fifty-one semi-structured interviews were completed with parent(s) of children who had attended a screening camp at the invitation of a Key Informant, but had not taken up their subsequent referral for health or rehabilitative services. Thematic analysis of the interview data resulted in emerging trends that were critically analysed according to the research objective.
  
  
  RESULTS
  Seven thematic reasons for non-uptake of referral were identified: severity of the disability; family and community; direct and associated cost; location of referral; negative camp experience; deliberate non-uptake; and procedural problems. Parents often discussed multiple reasons for non-uptake, interrelating socio-cultural, logistical and experiential factors.
  
  
  CONCLUSIONS
  Understanding the reasons for the parents of children with disability not taking up referral is important for the design and implementation of appropriate, relevant and contextual medical and rehabilitative services. The role of Key Informants may be developed from case detection, to include facilitation of effective and efficient uptake of services.
  
  
  CONCLUSIONS
  Programmes to identify children with disability and facilitate subsequent rehabilitation or treatment need to have extensive pre-planned strategies for referral mechanisms and follow up. Although Key Informants were not the focus of investigation, the present study suggests that there is potential for the role of the Key Informants to be extended beyond that of a case detection, to inform and facilitate referral processes and encourage the uptake of services.
authors.affiliation: Anthrologica , www.anthrologica.com .
authors.forename: Juliet
authors.initials: J
authors.lastname: Bedford
authors.forename: Sue
authors.initials: S
authors.lastname: Mackey
authors.forename: Afroza
authors.initials: A
authors.lastname: Parvin
authors.forename: Mohammad
authors.initials: M
authors.lastname: Muhit
authors.forename: G V S
authors.initials: GV
authors.lastname: Murthy
mesh_terms: D001459:Bangladesh; D002648:Child; D019988:Children with Disabilities / Q000534:rehabilitation / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance; D036301:Qualitative Research; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires