. 2018 Jun 14;13(6):e0198176. doi: 10.1371/journal.pone.0198176

Table 5. Illustrative statements on use of ZamCAT referral system.

	According to Health Workers
Effect of ZamCAT Referral System	“The ZamCAT messages affected us in a positive way, meaning that they were very helpful. When the field monitors visited the mother, they were able to detect those danger signs that the mother wouldn’t detect on their own and that was helpful as it made us to give treatment to the babies much earlier before something else worse happened. As I said the referral system was good because it made us attend to the children earlier and on time” (Enrolled Nurse, Monze District). “If there was a way of adopting it, it would be very beneficial because the system would continue and these children would be referred just the way they were referred on their own being brought to the clinic as early as possible (RM, Livingstone District)”
Recommendations for ZamCAT Referral System	“The referral system … I would say somehow we had no proper coordination of the same referral system because it like they were doing it on their own, thought we could see people coming but they were doing it on there own” (Enrolled Nurse, Kalomo District). The negative effects were that some mothers that were referred by the field monitors never used to come to the clinic due to unknown reasons (Community Health Worker, Monze District) The negatives that we had was sometimes we would refer a baby to the hospital then the mother on the way will decide when she reaches the hospital she decide to abscond and take the baby maybe to a traditional healer and then eventually you will hear the baby passed away” (Unknown, Livingstone District).

According to Health Workers

Effect of ZamCAT Referral System

“The ZamCAT messages affected us in a positive way, meaning that they were very helpful. When the field monitors visited the mother, they were able to detect those danger signs that the mother wouldn’t detect on their own and that was helpful as it made us to give treatment to the babies much earlier before something else worse happened. As I said the referral system was good because it made us attend to the children earlier and on time” (Enrolled Nurse, Monze District).
“If there was a way of adopting it, it would be very beneficial because the system would continue and these children would be referred just the way they were referred on their own being brought to the clinic as early as possible (RM, Livingstone District)”

Recommendations for ZamCAT Referral System

“The referral system … I would say somehow we had no proper coordination of the same referral system because it like they were doing it on their own, thought we could see people coming but they were doing it on there own” (Enrolled Nurse, Kalomo District).
The negative effects were that some mothers that were referred by the field monitors never used to come to the clinic due to unknown reasons (Community Health Worker, Monze District)
The negatives that we had was sometimes we would refer a baby to the hospital then the mother on the way will decide when she reaches the hospital she decide to abscond and take the baby maybe to a traditional healer and then eventually you will hear the baby passed away” (Unknown, Livingstone District).