Bakare A A, Uchendu O C, Sogbesan A A, Akinsola K O, Bakare O R, King C, Falade A G
Department of Community Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
Ann Ib Postgrad Med. 2025 Mar 31;23(1):24-37.
The "Child health card" (CHC) is integral to monitoring a child's growth and assessing development to support the early detection of malnutrition and prompt intervention. CHC is also valuable in keeping track of a child's vaccinations. There are limited studies on knowledge and utilization of CHC in Oyo state, Nigeria. We therefore aimed to assess caregiver's knowledge, retention, and utilization of child health cards in Ibadan, Oyo State, Nigeria.
A community-based mixed-method study using a parallel convergent design was employed. Quantitative data were collected from 617 caregivers at their compounds in the selected communities using an interviewer-administered questionnaire. Qualitative data were collected by interviewing caregivers and healthcare workers at health facilities. Bivariate analysis of quantitative indicators and thematic analysis of qualitative interviews were conducted.
Caregiver knowledge of the CHC, including the contents of the CHC and growth charts, was poor, but retention was relatively high (69.6%). Retention of the CHC was higher among caregivers whose index child was <12 months (p=0.011) and among those with good knowledge of the CHC (p<0.001). Being employed (p=0.016), having tertiary education (p=0.027), having good knowledge (p<0.001), and good perception of the CHC (p=0.001) were positively associated with the utilization of CHC. We found that when caregivers failed to present the card at immunization clinics, they often faced verbal reprimands from healthcare workers, and in some cases, their child's vaccination was denied.
CHC retention was high despite low utilization by caregivers. Therefore, interventions designed to improve community awareness of the CHC could provide an opportunity to improve the use of child health cards in this setting.
“儿童健康卡”（CHC）对于监测儿童生长发育、评估其发展状况以支持早期营养不良检测及及时干预至关重要。CHC在记录儿童疫苗接种情况方面也很有价值。在尼日利亚奥约州，关于CHC知识及使用情况的研究有限。因此，我们旨在评估尼日利亚奥约州伊巴丹地区照顾者对儿童健康卡的知识、留存率及使用情况。
采用基于社区的混合方法研究，运用平行收敛设计。通过访谈员协助的问卷从选定社区的617名照顾者居住场所收集定量数据。通过对照顾者和医疗机构医护人员进行访谈收集定性数据。对定量指标进行双变量分析，对定性访谈进行主题分析。
照顾者对CHC的知识，包括CHC内容和生长图表，掌握情况较差，但留存率相对较高（69.6%）。索引儿童年龄<12个月的照顾者（p=0.011）以及对CHC有良好知识的照顾者（p<0.001）中，CHC留存率更高。就业（p=0.016）、拥有高等教育（p=0.027）、有良好知识（p<0.001）以及对CHC有良好认知（p=0.001）与CHC的使用呈正相关。我们发现，当照顾者在免疫诊所未出示卡片时，他们经常会受到医护人员的口头斥责，在某些情况下，其孩子的疫苗接种会被拒绝。
尽管照顾者对CHC的使用率较低，但其留存率较高。因此，旨在提高社区对CHC认识的干预措施可能为改善该环境下儿童健康卡的使用提供机会。
