Private Sector Referral System

The SMS based system being proposed is designed to help more effectively track patients and determine what happens to them after they are referred.

The Challenge:

Reports indicate that more than 70% of malaria patients in Cambodia seek treatment via the private sector.   The Public-Private Mix (PPM) project, initiated by the Cambodia National Malaria Program (CNM) and partners, uses public sector staff to help select and train registered private providers in accordance with National Treatment Guidelines (NTG’s).  Among other things, private providers receive training on appropriate diagnosis, treatment and referral procedures.  In accordance with NTG’s, private providers in malaria risk zones 2 and 3 are permitted to diagnose and treat malaria cases although, children under five, pregnant women, and cases of serious/recurrent malaria should be referred to the public sector while private providers in malaria risk zone 1 should refer all malaria patients to the public sector.


Throughout this process, patients often fall through the cracks.  Many important questions are left unanswered, such as, do patients continue seeking treatment? where do they go?  why didn’t they go to the public sector in the first place?  Without the implementation of a tracking mechanism for these cases, it is impossible to know if these important patients are receiving the treatment they need.


Although mechanisms are in place to gather case data from selected private providers, it continues to be problematic to track referrals from the private to the public sector.  This population is often lost to follow up once they leave the private provider’s facility.

The Tool:

The InSTEDD iLab Southeast Asia worked closely with partners to design a more effective system that both the private and public sector can use in order to more effectively track patients and determine what happens to them after they are referred.


The Referral System is an SMS and web-based application that enables private providers to message information about each referred patient into an online database. The message from private providers include the referral slip number and the patient’s phone number. When the patient arrives at the public clinic, their referral slip information and patient ID number have already been sent to the system by the private sector health center.  By the time the patient arrives, their information has already been matched up with the original referral submitted by the private provider. With this information, the system at the Cambodia National Malaria Program (CNM) is able to monitor patients so that they can see who was referred and which patients have been accounted for at public facilities and which have not.


Below is the working flow of Referral System:

Learn more about this project on our Projects page here.