Abstract
Objectives: The child health card provides a way of following up all of the important aspects of a child’s health particularly immunization and nutrition. Two previous studies in Uganda showed that up to 57% of mothers did not have their children’s cards. This is likely to place the child’s health and well-being at risk. Factors responsible for the low use and retention of child health cards were not known. We set out to explore and identify factors affecting child health card use and retention, and its effects on immunization.
Methods: This was a cross-sectional household survey. The study population was children 0–24 months and their mothers/caretakers. A sampling frame of eligible households was generated with the assistance of local area officials. From the sampling frame (1126), 260 households were randomly selected. Data was analyzed using the Epi Info version 3.2.2. Odds Ratios and corresponding 95% confidence intervals were used to test for statistical significance. Logistic regression was used to control for confounding.
Results: Sixty-six percent of children had a child health card. Children delivered at a health facility were 4 times more likely to have a card compared to those delivered at home (AOR 3.74, 95% CI 1.35, 7.64). Children whose mothers had a health problem during pregnancy were 2(1/2) times more likely to have a card (AOR 2.4, 95% CI 1.23, 4.59), and children taken to a health facility in the 3 months preceding the survey were twice as likely to have a card (AOR 2.37, 95% CI 1.04, 3.96). Children who had cards were 10 times more likely to be up to date with the immunization schedule (OR=9.55, 95% CI 3.19, 29.45).
Conclusions: Child health cards help health workers and caretakers follow up child health issues, inherently promoting child health. The factors associated with card retention include whether the mother or child used a formal facility where cards are issued. It is therefore important that the health sector promotes the utilization of antenatal care, delivery, postnatal care and other services for mother and child.
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Acknowledgements
We acknowledge financial support toward this study from the Carnegie Corporation of New York. We wish to also acknowledge the contribution of our students who served as research assistants in the study namely: Alex Odama, Phyllis Kisa, Bishop Opira, Simon Aliga, Julius Sentongo, Esau Wasswa, Betty Lanyero, Noela Owarwo, Leaticia Kampiire, and Charles Dradu. Last but most certainly not least, we applaud the Mulago II Parish community for their participation in this study.
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David Odaka Mukanga David holds a bachelors degree in Pharmacy and a Masters degree in Public Health. He is a research fellow at the Makerere University Institute of Public Health were he teaches epidemiology and research methods. He has special interest in child survival research, evaluation of health interventions, and access to essential medicines. He is currently involved in a number of collaborative research projects on the private sector in Uganda. He also serves as coordinator for the Africa Field Epidemiology Network (AFENET) supported by USAID and the CDC.
Sarah Kiguli Sarah holds a bachelors degree in Medicine and Surgery, and a Masters degree in Paediatrics and Child Health. She is a senior lecturer at the Makerere University Medical School’s department of Paediatrics and Child Health.
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Mukanga, D.O., Kiguli, S. Factors Affecting the Retention and Use of Child Health Cards in a Slum Community in Kampala, Uganda, 2005. Matern Child Health J 10, 545–552 (2006). https://doi.org/10.1007/s10995-006-0132-9
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DOI: https://doi.org/10.1007/s10995-006-0132-9