Abstract
Mothers, caregivers, and healthcare providers in 163 countries have used paper and electronic home-based records (HBRs) to facilitate primary care visit. These standardized records have the potential to empower women, improve the quality of care for mothers and children and reduce health inequities. This review examines experiences of women, caregivers and providers with home-based records for maternal and child health and seeks to explore the feasibility, acceptability, affordability and equity of these interventions. We systematically searched MEDLINE, MEDLINE In-Process, MEDLINE Ahead of Print, Embase, CINAHL, ERIC, and PsycINFO for articles that were published between January 1992 and December 2017. We used the CASP checklist to assess study quality, a framework analysis to support synthesis, and GRADE-CERQual to assess the confidence in the key findings. Of 7,904 citations, 19 studies met our inclusion criteria. In these studies, mothers, caregivers and children shared HBR experiences in relation to maternal and child health which facilitated the monitoring of immunisations and child growth and development. Participants’ reports of HBRs acting as a point of commonality between patient and provider offer an explanation for their perceptions of improved communication and patient-centered care, and enhanced engagement and empowerment during pregnancy and childcare. Healthcare providers and nurses reported that the home-based record increased their feeling of connection with their patients. Although there were concerns around electronic records and confidentiality, there were no specific concerns reported for paper records. Mothers and other caregivers see home based records as having a pivotal role in facilitating primary care visits and enhancing healthcare for their families. The records’ potential could be limited by users concerns over confidentiality of electronic home-based records, or shortcomings in their design. Health systems should seize the opportunity HBRs provide in empowering women, especially in the contexts of lower literacy levels and weak health care delivery systems.
Highlights
The home-based record (HBR) offers an approach that women and countries can use to improve both the processes, such as communication and empowerment, and outcomes of health care, including pregnancy complications, child development and vaccination [1]
To achieve our study objective, this systematic review addresses the following key research question: Are HBRs for maternal, newborn and child health feasible, acceptable, affordable and equitable from the perspectives of women, family members, and health provider stakeholders? This review aims to understand the values that women and caregivers hold in relation to the use of these HBRs
A team of experts developed a protocol that considered the use, implementation and values that are relevant to mothers, caregivers, and healthcare provider stakeholders in low, middle- and high-income countries, in relation to the use of paper and electronic HBRs, which was published on the Cochrane Equity Methods website [18]
Summary
The home-based record (HBR) offers an approach that women and countries can use to improve both the processes, such as communication and empowerment, and outcomes of health care, including pregnancy complications, child development and vaccination [1]. The HBR is a document that may include components of preventive or curative antenatal, postnatal, newborn, and child health. Inequities in gender, age, socioeconomic status and ethnicity contribute to disempowerment [6, 7] Empowerment is both a process and an outcome that allows individuals to take control over their lives, set their own agendas, gain skills, increase self-confidence, solve problems, and develop self-reliance [8]
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