Technical Brief

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This issue of Technical Brief highlights the estimated ... Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam.
Issue 3: 2 Dec 2013

Technical Brief Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide

Increase in child health service coverage through MCH Handbook Dr. Hirotsugu Aiga, Chief Adviser

What change can the MCH Handbook make on child health? The Maternal & Child Health Handbook (MCHHB) is one of the self-monitoring and self-learning tools for pregnant women, mothers, children and family members. It is composed of recording section and reading section, which cover all the different MCH stages: (i) pregnancy; (ii) delivery and birth; (iii) post natal; (iv) neonatal; (v) infancy; (vi) under-five childhood. This issue of Technical Brief highlights the estimated effectiveness of the MCHHB on child health care.

The higher proportion of mother take MCHHBs to immunization services at commune health centers, the higher proportion of MCHHBs will have the immunization data on them (Figure 1). This implies, health workers are very likely to definitely record the immunization data on her MCHHB, once a mother brings it. In four Project’s pilot provinces (Dien Bien, Hoa Binh, Thanh Hoa, and An Giang), the use of immunization cards have been tentatively suspended, in order not to unnecessarily increase health workers’ workload by making them record the same data on both the MCHHBs and immunization cards. It seems that this way of implementing the MCHHB helps keep health workers encouraged to use the MCHHB. Well sustained Expanded Immunization Programme (EPI) Higher percentages in both these two indicators are attributable partially to the long-lasting Expanded Programme on Immunization (EPI) in Vietnam. Thanks to EPI! Both health workers and mothers have been informed and knowledgeable enough about the importance of EPI.

Handing a MCH Handbook to mothers in a rural commune health center, Hoa Binh province

Do mothers take the MCH Handbook for child immunizations? Overall, 90% of mothers take their MCHHBs to the commune health centers, when getting their children immunized. Similarly, the immunization data (date, health worker’s name, etc.) were recorded on 88% of MCHHBs mothers brought to commune health centers.

Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam Phone: +84-4-3736-8573, Fax: +84-4-3736-8574

Technical Brief: Issue 3 Increase in child health service coverage through MCH Handbook

The MCH Handbook helps further increase EPI coverage The comparison between baseline and end-line shows that the significant increases in the coverage of major immunizations, i.e. BCG, DPT, OPV and measles (Figure 2). This indicates that the introduction of the MCHHB contributed to further increase in the coverage of major immunizations, having admitted that the long-lasting EPI has built the rigorous basis for higher immunization coverage. Similar findings were reported from Indonesia (see Further reading).

Child development progress checklist The MCHHB includes one pager child health check-up to be conducted by health workers at 11 different age stages: (i) at birth; (ii) 1 week old; (iii) 2-6 weeks old; (iv)2-3 months old; (v) 4-6 months old; (vi) 7-9 months old; (vii) 10-12 months old; (viii) 13-18 months old; (ix) 19-23 months old; (x) 2-4 years old; (xi)5-6 years old. It also includes child development progress checklists to be completed by parents for 11 age stages. The examples of check-points are “Does your child look toward an object moving?” (for 2-3 months old), “Can your child roll over?”(4-6 months old) and “Can you stand holding something” (7-9 months old). Though child development progress data was recorded by parents on >40% of the MCHHBs till a child becomes 9 months old. Yet, parents tend to be less careful about the child development progress, by less frequently recording those data on the MCHHBs (Figure 3).

Child development checkpoints recorded by family members

Further reading:  VietHealth (2013) End-line survey for assessing the intervetnin of Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide. Hanoi: JICA  Osaki K, Hattori T, Kosen S, Singgih B. (2009), Investment in home-basd maternal, newborn an child records improves immunization coverage in Indonesia, Trans R Soc Trop Med Hyg. 103 (8) 846-848 .27 (2): .121-127.

Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam Phone: +84-4-3736-8573, Fax: +84-4-3736-8574