Abstract
Home-based records (HBRs) may improve the health of pregnant women, new mothers and their children, and support health care systems. We assessed the effectiveness of HBRs on maternal, newborn and child health reporting, care seeking and self-care practice, mortality, morbidity and women’s empowerment in low-, middle- and high-income countries. We conducted a systematic search in MEDLINE, EMBASE, CENTRAL, Health Systems Evidence, CINAHL, HTA database, NHS EED, and DARE from 1950 to 2017. We also searched the WHO, CDC, ECDC, JICA and UNAIDS. We included randomised controlled trials, prospective controlled trials, and cost-effectiveness studies. We used the Cochrane Risk of Bias tool to appraise studies. We extracted and analyzed data for outcomes including maternal, newborn and child health, and women’s empowerment. We synthesized and presented data using GRADE Evidence Profiles. We included 14 studies out of 16,419 identified articles. HBRs improved antenatal care and reduced likelihood of pregnancy complications; improved patient–provider communication and enhanced women’s feelings of control and empowerment; and improved rates of vaccination among children (OR: 2·39, 95% CI: 1.45–3·92) and mothers (OR 1·98 95% CI:1·29–3·04). A three-year follow-up shows that HBRs reduced risk of cognitive delay in children (p = 0.007). HBRs used during the life cycle of women and children in Indonesia showed benefits for continuity of care. There were no significant effects on healthy pregnancy behaviors such as smoking and consumption of alcohol during pregnancy. There were no statistically significant effects on newborn health outcomes. We did not identify any formal studies on cost or economic evaluation. HBRs show modest but important health effects for women and children. These effects with minimal-to-no harms, multiplied across a population, could play an important role in reducing health inequities in maternal, newborn, and child health.
Highlights
Home-based records (HBRs) are used in over 163 countries or territories [1]
Use of HBRs is inconsistent across and within countries; and despite the benefits shown in primary studies, parents and health care practitioners often underutilize HBRs or use them inappropriately [1, 3]
This study aims to determine whether particular types of HBRs improve these outcomes more than others
Summary
Home-based records (HBRs) are used in over 163 countries or territories [1]. These records are paper or electronic documents that pregnant women and caregivers commonly maintain and use in the household to monitor the health of the household’s children. The contents of HBRs cover one or more components of preventive or curative antenatal, postnatal, newborn, and child health, including vaccination and nutrition. These records may improve maternal, newborn and child health and development in both developed and developing countries [2,3,4]. Use of HBRs is inconsistent across and within countries; and despite the benefits shown in primary studies, parents and health care practitioners often underutilize HBRs or use them inappropriately [1, 3]
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