Home-based Maternal Records

Book excerpt: A comprehensive guide to all aspects of the development, adaptation, and use of home-based maternal records as an exciting new tool for reducing maternal and perinatal morbidity and mortality. Home-based maternal records, which are retained by the woman and serve as her "passport" to appropriate health care, are simple cards designed to facilitate the easy recording and interpretation of comprehensive information on the health status of a woman before her first pregnancy, during the current pregnancy, delivery, postpartum and neonatal periods, and during two subsequent pregnancies. The cards can also be used to record information during the periods between pregnancies and on the woman's breast-feeding, family planning, and tetanus toxoid immunization status. Though simple in concept and design, the cards have demonstrated their effectiveness as a tool for the early detection of risk factors, the promotion of timely referral, the monitoring of women's health for periods of up to 10 years, and the education of women about health, nutrition, and family planning. Home-based maternal records have also shown their potential to encourage more appropriate referrals and better utilization of health services, to promote self-diagnosis and self-care, to foster greater community involvement, and to facilitate the collection of health information. Designed to help program managers and administrators introduce and use home-based maternal records to the greatest effect, the book draws on experiences and lessons learned during the extensive field testing of home-based. While a WHO prototype record is presented as a model, emphasis is placed on the best ways to adapt this prototype to local conditions, test its effectiveness, pinpoint problems, and find solutions, even when resources are scarce and populations largely illiterate.