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Referral Slips Increase Adolescents' Access to Health Care

Adolescent girls with their A2H referral slips wait to see the health service provider.

Adolescent girls with their A2H referral slips wait to see the health service provider.

Ayesha, Monira, Sadia, and Sumaiya are classmates and friends living in Rangpur Sadar Upazila.

Like many girls their age going through puberty, they have faced health issues—including menstrual pain, irregular cycles, physical weakness, and leukorrhea.

“Despite their difficulties, the girls have been told they should be more tolerant,” Monira says, adding, “It’s not a problem for which we need to go to the doctor!”

Ayesha adds, “We hear that these are the secret problems of girls and to talk about these is shameful matter.”

As a result of these comments, the girls felt that they could not consult with a doctor and began hiding their physical ailments.

“During the menstruation time we used to drop out of school. I face heavy bleeding and severe cramps—it’s really very painful. I have read in my textbook that we need to go to doctors for this, but I couldn’t convince my family members to take me to the clinic. Sometimes, my friends and I discussed going to the nearby clinic together, but didn’t have the courage. We didn’t know how to explain our problems to the doctor,” Sadia says.

The girls share their experiences while sitting in the waiting area of the Rajendrapur Union Health and Family Planning Center.

They have come to consult with the health service provider during their school break time.

Ayesha meets with her community facilitator to discuss her health issues.

Ayesha meets with the community health facilitator to discuss her health issues and reviews information in Njeke D'jano booklets that have been provided by the project.

In addition to their medical problems, all of the girls share something else they had in common—a referral slip.

“Our problem is mentioned in this slip. We just need to show this to the doctor [health service provider]. It makes our lives easier—doctors see the problems written here and consult with us accordingly. When required, they prescribe us medicine. We don’t feel hesitant anymore,” Sumaiya says.

So, what suddenly made them decide to visit their health service provider?

Ayesha credits the life skill sessions of the Advancing Adolescent Health (A2H) project.

“There we learned about the services provided by the health centers. When we shared our problem, Apa* gave us a referral slip and referred us to this clinic. This health center is very near to our school—only five minutes walking distance. It’s easy for us to come here during the break time. There is another health center in my village, but it is far from my home. So, I prefer to come here where I can be with my friends. When we show the referral slip to the doctors, they listen to us more carefully because we came from the project. Sometimes, Apa also comes with us and helps us to visit the doctors. We don’t feel afraid or shy anymore.”

While she was sharing her story, Ayesha’s name was called and she went to the service provider’s room.

After leaving her appointment with the service provider, she seemed relieved.

“I came here with the problem of white discharge, and it was written in my referral slip. The doctor listened to my problem and advised me of some hygiene tips to get rid of this; she also suggested eating nutritious foods which will keep me fit,” she says.

Like Ayesha and her friends, many other adolescent girls in Rangpur district are benefiting from A2H project’s referral service.

The referral slip can be completed by both community facilitators and adolescent leaders, and each referral is recorded in their registrar’s book. These records help the health care providers and A2H staff conduct follow-up visits.

“Today, I came here for follow-up. I visited the doctor last month with menstrual pain and she prescribed me some medicine and told me to come back one month later. My menstrual cycle for this month is near and I want to cross-check whether I will continue the medicine or not,” Monira says.

*An "Apa" is the community facilitator.

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