Author(s): Kumar R, Kumar R
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Abstract In order to simplify the collection, recording and reporting of information on maternal and child health care in a rural area of India, a home-based mother and child card and a tally sheet were introduced. This has made it possible for the community to evaluate the services provided. PIP: A sample survey of households in 5 primary health districts in India showed that health center records grossly underreported birth and infant mortality rates (18/1000 reported vs. 34.4/1000 actual and 20/1000 reported vs. 51/1000 actual, respectively). Therefore, the data collection and reporting system was reviewed with input from the health workers who maintained the system. The system was found to be too cumbersome and time-consuming, with similar entries often required in several registers; all records were incomplete. To correct this situation, a simplified record keeping system was devised using a home-based mother and child health card and a tally sheet and retaining the family register, diary of visits, and registers of patients and stocks from the old system. Separate family registers were made for each village and were alphabetized by head of household. Information from the diaries of house visits and patients registered was entered in the family register and tally sheets in a daily basis. The tallies were used in monthly reports for submission to the primary health centers. After 6 months, 14 health workers reported improvement in the system; however only 7 family registers were up-to-date and, although the tally sheets were properly completed, workers continued to underreport vital events showing a (24.4/1000 birth rate and 22.5/1000 infant mortality rate). This system, nevertheless, has the advantage of reducing needless duplication of reporting. Its main advantage, however, is the fact that the mothers now have an information card detailing the services they have received. This allows information to flow into the community, not just to the major health centers, and eases the coordination of efforts of various providers of maternal and child health services. The card reminds mothers about services needed and services as a check list for health workers. Vital events remained grossly underreported because senior administrators were more interested in service statistics, particularly family planning services, and gave workers the impression that it was not important to spend time detailing vital statistics. Commitment by supervisors is necessary to improve data collection further.
This article was published in World Health Forum
and referenced in Advanced Practices in Nursing