Factors Affecting the Retention and Use of Child Health Cards in a Slum Community in Kampala, Uganda, 2005
- 196 Downloads
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.
KeywordsChild-health-card Retention Factors Immunization Uganda
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.
- 1.The World Bank. World Development Report 1993: Investing in health. New York: Oxford University Press, 1993Google Scholar
- 3.Uganda Bureau of Statistics, ORC Macro. The Uganda Demographic and Health Survey 2000–2001Google Scholar
- 4.Ministry of Health, Uganda. How to use the Child Health Card A guide for Health Workers in Uganda, 1984Google Scholar
- 5.Uganda Bureau of Statistics, ORC Macro. The Uganda Demographic and Health Survey 2000–2001Google Scholar
- 6.Bukenya G. Knowledege, Attitudes and Practices Study on Immunisation Services in Uganda. Unpublished Report 1998Google Scholar
- 7.Rujumba J, Mworozi A. Immunization Status of Children presenting at the Acute Care Unit Mulago hospital. Unpublished Report 2003Google Scholar
- 8.Draecabo C. Knowledge and Utilisation of Child Immunisation Services by mothers in Arua District. Unpublished Report 1994Google Scholar
- 9.Mukanga D, Kiguli S. Reasons why mothers and caretakers loose Child health cards in the Mulago Community. Unpublished Report 2004Google Scholar
- 10.Kish L. Survey Sampling. New York, NY: John Wiley & Sons, Inc. 1965Google Scholar