Completeness of patient-held records: observations of the Road-to-Health Booklet from two national facility-based surveys at 6 weeks postpartum, South Africa

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dc.contributor.author Ramraj, Trisha
dc.contributor.author Goga, Ameena Ebrahim
dc.contributor.author Larsen, Anna
dc.contributor.author Ramokolo, Vundli
dc.contributor.author Bhardwaj, Sanjan
dc.contributor.author Chirinda, Witness
dc.contributor.author Nsibande, Duduzile
dc.contributor.author Ayalew, Kassahun
dc.contributor.author Pillay, Yogan
dc.contributor.author Lombard, Carl J.
dc.contributor.author Ngandu, Nobubelo K.
dc.contributor.author for the South Africa PMTCT Evaluation (SAPMCTE) Team
dc.date.accessioned 2019-06-12T09:02:37Z
dc.date.available 2019-06-12T09:02:37Z
dc.date.issued 2018-12
dc.description.abstract BACKGROUND : Continuity of care is important for child well-being in all settings where postnatal retention of mother-infant pairs in care remains a challenge. This analysis reports on completeness of patient-held infant Road to Health Booklets (RtHBs), amongst HIV exposed and unexposed infants during the first two years after the RtHB was launched country-wide in South Africa. METHODS : Secondary data were analysed from two nationally representative, cross-sectional surveys, conducted in 2011-12 and 2012-13. These surveys aimed to measure early effectiveness of the national programme for preventing vertical HIV transmission. Participants were eligible for this analysis if they were 4-8 weeks old, receiving their six-week immunisation, not needing emergency care and had their RtHBs reviewed. Caregivers were interviewed and data abstracted from RtHBs. RtHB completeness across both surveys was defined as the proportion of RtHBs with any of the following indicators recorded: infant birth weight, BCG immunisation, maternal syphilis results and maternal HIV status. A partial proportional odds logistic regression model was used to identify factors associated with completeness. Survey sampling weights were included in all analyses. RESULTS : Data from 10 415 (99.6%) participants in 2011-12 and 9529 (99.2%) in 2012-13 were analysed. Overall, recording of all four indicators increased from 23.1% (95% confidence interval (CI)  = 22.2-24.0) in 2011-12 to 43.3% (95% CI = 42.3-44.4) in 2012-13. In multivariable models, expected RtHB completeness (ie, recording all four indicators vs recording of <4 indicators), was significantly (P<0.05) associated with survey year, marital status, socio-economic status, maternal antenatal TB screening, antenatal infant feeding counselling, delivery at a clinic or hospital and type of birth attendant. CONCLUSIONS : Routine patient-held infant health RtHB, a critical tool for continuity of care in high HIV/TB prevalence settings, was poorly completed, with less than 50% of the RtHB showing expected completeness. However, government efforts for improved usage of the booklet were evidenced by the near doubling of completeness from 2011 to 2013. Education about its importance and interventions aiming at optimising its use without violating user privacy should be continued. en_ZA
dc.description.department Paediatrics and Child Health en_ZA
dc.description.librarian am2019 en_ZA
dc.description.sponsorship This paper was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention, under the terms of Cooperative Agreement Number 5U2GPS001137-4. UNICEF and the National Department of Health provided both technical and financial support; the South African National AIDS Council, European Union (through the National Department of Health), the South African National Research Foundation and the Global Fund also provided financial support. This work was supported by the South African Medical Research Council. AEG, CJL & NKN were financially supported by the South African Medical Research Council. en_ZA
dc.description.uri http://www.jogh.org en_ZA
dc.identifier.citation Ramraj, T., Goga, A.E., Larsen, A. et al. 2018, 'Completeness of patient-held records: observations of the Road-to-Health Booklet from two national facility-based surveys at 6 weeks postpartum, South Africa', Journal of Global Health, vol. 8, no. 2, pp. 1-13. en_ZA
dc.identifier.issn 2047-2978 (print)
dc.identifier.issn 2047-2986 (online)
dc.identifier.other 10.7189/jogh.08.020901
dc.identifier.uri http://hdl.handle.net/2263/70153
dc.language.iso en en_ZA
dc.publisher Edinburgh University Global Health Society en_ZA
dc.rights This work is licensed under a Creative Commons Attribution 4.0 International License. en_ZA
dc.subject Road to health booklet (RtHB) en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Patient-held records en_ZA
dc.subject Child well-being en_ZA
dc.title Completeness of patient-held records: observations of the Road-to-Health Booklet from two national facility-based surveys at 6 weeks postpartum, South Africa en_ZA
dc.type Article en_ZA


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