Home-based records for maternal, newborn and child health
WHO has today launched recommendations on the use of home-based records for maternal, newborn and child health.
Home-based records have been widely implemented for decades and they are currently in use in at least 163 countries. However, they vary greatly in their design and content across countries and regions and the evidence of their benefits and harms has not been systematically reviewed and summarized. This new guideline seeks to address this gap by reviewing the evidence of the effects of home-based records on maternal, newborn and child health outcomes and health service delivery outcomes.
What is a home-based record?
A home-based record is a record of an individual’s health status and their history of health services received (primarily MNCH), The record is kept in the household by the client (e.g. a woman holds a maternal health record) or by the caregiver (e.g. the parent/guardian holds the infant’s health record).
There are many different types of home-based records including:
- antenatal notes
- vaccination-only cards/booklets
- vaccination-plus cards/booklets
- child health books
- integrated maternal and child (MCH) health books.
WHO recommends home-based records, as a complement to facility-based records, for the care of pregnant women, mothers, newborns and children, to improve:
- care-seeking behaviours,
- male involvement and support in the household,
- maternal and child home care practices,
- infant and child feeding, and
- communication between health providers and women/caregivers.
One question of interest was if different types of records had different impact. Insufficient evidence is available to determine if any specific type, format or design of home-based records is more effective. Policy-makers should involve stakeholders to discuss the important considerations with respect to type, content and implementation of home-based records.
The guideline is intended to be used by policy-makers and programme managers to help them decide whether home-based records should feature more prominently in MNCH programmes, and to encourage more effective implementation. The findings and the recommendations will enable country-level decision-makers and health care providers to better understand:
- the value of home-based records;
- their impact on a broad set of outcomes;
- their potential contribution to strengthening the quality of health service delivery and health systems.
The guideline also highlights important implementation considerations. Every stage of the implementation process – from design to the training of providers, to utilization by end-users – should be planned and funded, as each stage can affect the home-based record’s potential impact on outcomes.
Multiple research gaps were also identified and we hope this will guide future research and strengthen the evidence base.