Factors affecting the retention and use of child health cards in a slum community in Kampala, Uganda, 2005.
OBJECTIVE
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.
Mukanga
David O
DO
Department of Epidemiology and Biostatistics, Makerere University Institute of Public Health, P. O. Box 7072, Kampala, Uganda, dmukanga@iph.ac.ug.
Kiguli
Sarah
S
D000328:Adult; D017028:Caregivers / Q000193:education* / Q000706:statistics & numerical data; D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D009035:Mothers / Q000193:education* / Q000706:statistics & numerical data; D011204:Poverty Areas; D012959:Socioeconomic Factors; D014454:Uganda