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Accra anemia Annex applied arrive Atwima barriers to compliance BASlCS Caretaker interviews caretakers of children causes of referral cedis centers and district children less chloramphenicol CHPS Circle clinic compliance rate compliance with referral complied with referral conducted consulting room register convulsions diarrhea diazepam district hospitals facility code FGDs focus group discussions Gambia Ghana Health Service health centers health facilities Health Provider Interview health workers informed consent John Snow Kumasi less than five level facilities lf the child lMCl guidelines lnstrument Lumbar puncture malaria Management of Childhood median Medical Record Review mothers NHMlS number of referrals percent of providers providers thought Questionnaire code QUESTlON referral facility Referral Pathways referral rate referral site referral slips Referred Child referred children Regional Hospital requiring referral severely ill children sick children specify statistically significant difference surveyors teaching hospitals three districts visited World Health Organization Yendi