Utilisation of the mother-child health booklet by healthcare workers and caregivers at Mbagathi District Hospital

Abstract

Introduction: The Mother Child Health (MCH) booklet is a home based record for an expectant mother and subsequently the child. Active usage of this booklet has been shown to reduce both maternal mortality ratio and under five mortality rate. The booklet was launched in Kenya in 2010.This study evaluated its utilisation at Mbagathi District Hospital by both healthcare workers and caregivers. Objectives: The primary objective was to determine the fill-in rate of the various sections of the MCH booklet. The secondary objectives were to determine the socio-demographic factors of the caregivers that affect the utilisation of the MCH booklet and the barriers to the utilisation of the MCH booklet by both caregivers and healthcare workers. Study design: This was a hospital based descriptive cross-sectional study. Study methods: All caregivers of children aged 2 to 12 months attending the Mother Child Health clinic at Mbagathi District Hospital were eligible for the study. Once the caregivers were enrolled a predesigned questionnaire was administered to them. The MCH booklet was then scrutinized using a predesigned checklist to ascertain what had been recorded predominantly in the child health section of the booklet. The healthcare workers self-administered a different questionnaire. Results: Three hundred and twenty two mother-child pairs and 6 health workers were enrolled into the study. The fill in rate for most sections of the booklet was not adequate apart from particulars of the child (97.8%), immunisation (99.1%), weight for age chart (99.7%), height for age chart (97.8%) and growth monitoring return date (90.1%). The sections for ‘early identification of eye problems’ and ‘reasons for special care’ were not filled in at all. The fill in rate for the others sections were as follows; delivery records (12.8%), developmental milestones (3.7%), postnatal examination (9.3%), infant feeding counseling (9.6%) and identification of HIV exposed (0.6%).There was a strong association between utilisation and level of education for caregivers aOR 3.65(95%CI 1.49-8.94 p = 0.005) and a history of previous child loss aOR 0.34(95% CI 0.16-0.87 p = 0.03). The barriers to utilisation by healthcare workers were heavy workload and lack of training.