Taylor Amelia, Kazembe Paul
Malawi University of Business and Applied Sciences, Blantyre, Malawi.
INSPIRE Network, Kuyesera AI Lab, Blantyre, Malawi.
BMC Health Serv Res. 2025 Jun 3;25(1):792. doi: 10.1186/s12913-025-12844-0.
Health Passports (HPs) are paper-based, patient-held records used in Malawi to document key details about the health condition of a patient and the care provided during medical visits.
This paper assessed their use and effectiveness within the health data ecosystem, and their potential impact on patient care.
The study setting was health facilities under the District Health Office in the Zomba District, Malawi.
We undertook a qualitative study to determine the practices for data recording used by health care professionals and the importance placed on HPs by patients and professionals. We conducted an in-depth Focus Group Discussion with healthcare practitioners. Pages from completed HPs were analysed to extract practices for recording case presentation, diagnosis, and medication.
HPs were perceived to be beneficial to healthcare professionals as a means of transmitting information and communicate to each other the patient record history and treatment. Patients saw HPs solely as means of accessing services rather than as sources of personal health information with intrinsic value to them. Practices in recording patient notes varied considerably and we found many instances of illegible handwriting, and the use of abbreviations and shorthand that could be interpreted differently by clinicians and were not understood by patients. Language and communication barriers, low patient literacy and a general lack of privacy during consultations also had a significant negative effect on the use and effectiveness of HPs.
There are significant gaps between the intended use and effectiveness of HPs in a clinical setting and the actual use by healthcare professionals and patients. Efforts to make sure that HPs can effectively fulfil the primary purpose of medical records are long overdue.
This study contributes to an under-researched area for understanding the use and effectiveness of patient-held records in LMICs.
健康护照（HPs）是马拉维使用的纸质、由患者持有的记录，用于记录患者健康状况的关键细节以及就诊期间接受的护理。
本文评估了它们在健康数据生态系统中的使用情况和有效性，以及它们对患者护理的潜在影响。
研究背景是马拉维宗巴区卫生办公室下属的医疗机构。
我们进行了一项定性研究，以确定医疗保健专业人员使用的数据记录做法，以及患者和专业人员对健康护照的重视程度。我们与医疗从业者进行了深入的焦点小组讨论。对已填写的健康护照页面进行分析，以提取记录病例陈述、诊断和用药的做法。
健康护照被认为对医疗保健专业人员有益，是传递信息以及相互交流患者记录历史和治疗情况的一种方式。患者仅将健康护照视为获取服务的手段，而非对他们具有内在价值的个人健康信息来源。记录患者笔记的做法差异很大，我们发现有许多字迹难以辨认的情况，以及使用了临床医生可能有不同解读且患者不理解的缩写和速记。语言和沟通障碍、患者识字率低以及咨询期间普遍缺乏隐私，也对健康护照的使用和有效性产生了重大负面影响。
健康护照在临床环境中的预期用途和有效性与医疗保健专业人员和患者的实际使用之间存在重大差距。早就应该努力确保健康护照能够有效实现病历的主要目的。
本研究为一个研究不足的领域做出了贡献，该领域旨在了解低收入和中等收入国家患者持有的记录的使用情况和有效性。
