The study suggests that information on available services should be made known to health workers. Frequent meetings between different service sites should be organized, with the involvement of high-level health staff that can make decisions, to update information on services available and provide feedback on the quality of the referral system. Development of a practical strategy is needed to strengthen and adapt the referral system to meet the needs of patients. For example, comprehensive services for HIVinfected people should be provided at one service site at district level [2].