Quality and Use of Recording Fields in Home-Based Records Collected through a Missed Opportunities for Vaccination Assessment in Mozambique, 2017

Abstract

Introduction: More than 163 countries use a form of home-based record which is a health document used to record the history of health services received by an individual. These records provide health workers with a standardized format to record receipt of these health services, such as vaccination history and enable them to make informed decisions about vaccine eligibility. However, implementation challenges, such as incorrect use of home-based records by health workers, persist and recent findings from a Missed Opportunities for Vaccination (MOV) assessment in Mozambique indicate poor vaccination recording practices as a challenge. Methods: This descriptive, secondary analysis of home-based record photos collected through a MOV assessment in Mozambique in 2017 aims to document the quality and use of selected recording fields in the home-based records. A data extraction form with 25 variables was generated in excel to capture information about the type of home-based record in the photo, the physical quality and availability and use of fields to record a child’s vaccination history, growth monitoring, vitamin A for the child, deworming, and vitamin A for the mother. Results: Data from a total of 472 photos of home-based records were extracted and included in the analysis. The majority of home-based records (n = 440; 93.2%) were in good condition, and most children were <6 months of age (n = 215; 45.6%). More than half (n = 289; 61.9%) of the official home-based records from Mozambique (n = 467) were up-to-date versions. Except for eight (1.7%) home-based records that had blank vaccination recording fields, all other records (n = 464; 98.3%) recorded information on the child’s vaccination history, though suboptimal recording practices were observed. Other recording fields were less frequently filled in. Conclusion: The results indicate the common use of outdated home-based records, which were missing fields to record all vaccines a child was eligible for in 2017. Furthermore, suboptimal recording practices by health workers were observed, as well as a need to improve the record’s design.