Original Research

Completeness of the Road-to-Health Booklet and Road-to-Health Card: Results of cross-sectional surveillance at a provincial tertiary hospital

Harishia Naidoo, Theunis Avenant, Ameena Goga
Southern African Journal of HIV Medicine | Vol 19, No 1 | a765 | DOI: https://doi.org/10.4102/sajhivmed.v19i1.765 | © 2018 Harishia Naidoo, Theunis Avenant, Ameena Goga | This work is licensed under CC Attribution 4.0
Submitted: 17 May 2017 | Published: 10 April 2018

About the author(s)

Harishia Naidoo, Department of Paediatrics and Child Health, Tembisa Provincial Tertiary Hospital, University of Pretoria, South Africa
Theunis Avenant, Department of Paediatrics, Kalafong Provincial Tertiary Hospital, University of Pretoria, South Africa
Ameena Goga, Department of Paediatrics, Kalafong Provincial Tertiary Hospital, University of Pretoria, South Africa and Health Systems Research Unit, South African Medical Research Council, South Africa


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Abstract

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 socio-demographic 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.


Keywords

Road to Health Booklet; Toad to Health Card

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