An assessment by nurses and mothers of a ‘road-to-health ’ book in the Western Cape

Abstract

<strong>Objectives:</strong> To evaluate English, Afrikaans, and Xhosa mother-retained ‘Road-to- Health Book’ (RTH book) for children, and an electronic calculator.<br /> <strong>Design: </strong> Researchers D Harrison (DH) and H Harker (HH) informed clinic staff about the contents and significance of the RTH book. They requested nurses to use this book in conjunction with the Road-to-Health Card and to issue and explain its use to every visiting client. The use of an electronic calculator that plotted horizontal centile and Z-score charts was demonstrated and explained. To determine the relevance of the book and the electronic calculator, nurses involved in the study for 6 months were given three standardised descriptive questionnaires with ‘yes’, ‘no’ and ‘don’t know’ responses. Clients were traced and interviewed by the researchers after 6 -1 2 months to obtain their views on the book. <br /> <strong>Setting: </strong> Clinics that provided children with healthcare in 24 locations in the Western Cape Province participated in the study. The children lived in informal settlements, in low-, middle- and high-income residential areas, and on farms in the Cape Town. Stellenbosch, and Paarl regions. <br /> <strong>Subjects: </strong> One hundred and fourteen nurses were enrolled in the study as well as 581 clients to whom the RTH book was issued. <br /> <strong>Outcome measures: </strong> The use of and comments on the RTH book by nurses and clients were based on analysis of the questionnaires. <br /> <strong>Results: </strong> The majority of nurses (81.6%) and clients (96%) found the RTH book useful. The horizontal and Z-score growth charts and electronic calculator were less acceptable because their use was time-consuming and less well understood. <br /> <strong>Conclusion: </strong> The RTH book with appropriate modifications should be issued to clients in place of the current Road-to-Health card and educational material

How Should Home-Based Maternal and Child Health Records Be Implemented? A Global Framework Analysis

“…18,19 Our sources echoed existing studies advocating that HBRs should be created in regional languages. For example, the Road to Health card in South Africa was printed in English, Afrikaans, and Xhosa, 21 and the Patient Passport in the USA had better impact when there was a concurrent Spanish version. 35 An informal review conducted by Brown showed that the health messages in HBRs were often poorly aligned to national literacy levels.…”

“…Existing literature has examined selected aspects of implementation, some slightly more than others, namely design of the HBR 2,[16][17][18][19][20] and promotion of end user engagement. [21][22][23][24] However, substantial operational challenges still remain even in these areas and require further research. 14,25 The majority of existing literature studied HBRs in high-income countries.…”

Towards a sustainable community database: taking advantage of the Road-to-Health cards to monitor and evaluate health interventions targeting under fives

“…In addition to being useful in the follow up of individual child health care through the referral ladder the notes can also serve as a database for future research. Despite some limitations in recording disease data (Tarwa & Villiers, 2007) other studies have shown such a book to be acceptable by the majority of the health workers and clients (Harrison et al, 2005).…”

Descriptive study evaluating the use of the Road to Health card by doctors in a tertiary Paediatric hospital setting

“…[6] Numerous international and local studies have highlighted three weak links in the use of the PCHR by health professionals: failure to request the record from the caregiver, failure to use the record as a reference source of the child's medical background, and failure to comprehensively and accurately record new information in the record. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] Much of the research on the weak links has relied on participant recall, which in many cases has not matched the health professional's medical notes. Few studies have examined both the PCHR and institutional clinical records to determine what information has been transferred in either direction.…”