BACKGROUND : Accurate record-keeping is important for continuity and quality of care.
Completing a child’s Road-to-Health Booklet (RTHB), or the older, less detailed, Road-to-
Health Card/Chart (RTHC), immediate interpretation thereof and appropriate action facilitates
comprehensive care, which could contribute to a decline in child morbidity and mortality.
OBJECTIVE : This study aimed to assess the extent to which healthcare personnel working
in catchment clinics of Kalafong Provincial Tertiary Hospital (KPTH), Tshwane district,
South Africa, complete HIV-related, sociodemographic, neonatal, growth and immunisation
information in the RTHC and/or RTHB.
METHODS : A cross-sectional, quantitative record review was conducted. Data were extracted
from 318 RTHCs and/or RTHBs of children attending KPTH for paediatric care. Data extraction
focused on six main areas, namely documentation of HIV-related, neonatal, sociodemographic,
anthropometric, immunisation and vitamin A-related information. During data analysis,
age-appropriate completeness scores were generated for each area and completeness of
documentation in the RTHB and RTHC was assessed.
RESULTS : Data demonstrate significantly less unrecorded HIV-related information (maternal
HIV status, timing of maternal HIV testing, timing of maternal antiretroviral therapy [ART]
initiation, current maternal ART use and infant feeding decisions) in RTHBs compared with
RTHCs (p < 001). Despite this, 24% of all RTHBs had no record of maternal HIV status and 67%
of RTHBs from documented HIV-exposed infants had no record of maternal ART duration.
Neonatal information completeness was similar between RTHBs and RTHCs, but sociodemographic
completeness was significantly better in RTHBs compared with RTHCs (p = 0.006). Growth (especially weight), immunisation and vitamin A completeness was > 80%
and similar between RTHBs and RTHCs. Length-for-age, weight-for-length and head
circumference were plotted in < 5% of RTHBs and none of the RTHCs.
CONCLUSION : Although completeness of key HIV-related information was better in RTHBs
compared with RTHCs, RTHB completeness was suboptimal. Healthcare personnel need
reminders to utilise the RTHB optimally to improve continuity and quality of child healthcare.
Nkosi, Thobeka(University of Pretoria, 2008-07-29)
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