title: Factors Determining Availability, Utilization and Retention of Child Health Card in Western Nepal.
abstract: BACKGROUND
  The immunization card is revised with addition of general information about child health and is later called as child health card. This card is a tool used by Health Management Information System in Nepal. It is important for tracking the records of immunization. Aim is to identify the factors determining the availability, utilization and retention of the child health card in Western Nepal.
  
  
  METHODS
  A cross sectional study was conducted among mothers having children < 24 months old from Gorkha (Western Hill) and Nawalparasi (Western Terai) districts. The sample size for the study was 600 and systematic random sampling was used to select the mothers having less than 24 months old children. Data entry and analysis was done by using SPSS. Qualitative data was analyzed by making matrix.
  
  
  RESULTS
  The average age of respondents was 24 years. The majority of respondents have gained higher level education. Retention of the card was found to be 82.2%. 90.3% retention was seen among 0-12 months children age group whereas it was 74 % among12 to 24 months age group. The reasons for less retention were torn by the child/played by child (54.6%) followed by lack of proper place,unaware about importance and poor quality of card.The new child health cards were insufficient, compelling use of both new and old cards which created problem in consistency. Regarding utilization of child health card, it was found to be used for birth registration and for further studies in abroad.
  
  
  CONCLUSIONS
  The areas of utilization of child health card should be broadened so that the retention of card can be increased. The main reasons for less retention of the card are torn by children and lack of the proper place.
authors.affiliation: Child Health Division, Department of Health Sciences, Ministry of Health, Nepal.
authors.forename: K P
authors.initials: KP
authors.lastname: Paudel
authors.affiliation: Group for Technical Assistance, Nepal.
authors.forename: D C
authors.initials: DC
authors.lastname: Bajracharya
authors.affiliation: Group for Technical Assistance, Nepal.
authors.forename: K
authors.initials: K
authors.lastname: Karki
authors.affiliation: UNICEF Country Office Nepal, Nepal.
authors.forename: A
authors.initials: A
authors.lastname: K C
mesh_terms: D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D004282:Documentation / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D009390:Nepal; D055815:Young Adult
keywords: Availability; retention; utilization; vaccination card.