Technical Brief. Project for Implementing Maternal and ... Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam.
Issue 2: 15 Nov 2013
Technical Brief Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide
Behavior changes on antenatal care through the MCH Handbook Dr. Hirotsugu Aiga, Chief Adviser
What is the Maternal & Child Health Handbook? The Maternal & Child Health Handbook (MCHHB) is one of the self-monitoring and self-learning tools for pregnant women, mothers, children and family members. The MCHHB helps and encourages them to monitor pregnancy and child development. It also serves as the useful referral tool, as pregnant women and mother rationally choose the most appropriate health facility according to types of health services they are seeking. The MCHHB is expected to contribute to better achieving the Millennium Development Goals related to maternal and child health.
What changes the Maternal & Child Health Handbook made? The survey conducted structured interviews with a total of 810 mothers who received the MCHHB at the time of their pregnancy during 2011. Moreover, the MCHHBs were systematically observed. Mothers’ knowledge on pregnancy In all four provinces, mothers’ knowledge on danger signs during pregnancy improved, compared with baseline in 2011 (Figure 1). These significant improvement of mothers’ knowledge is attributable to their routine practices of reading the maternal guidance part of the MCHHB.
Since 2011, Ministry of Health and Japan International Cooperation Agency (JICA) has been implementing the Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide in Dien Bien, Hoa Binh, Thanh Hoa and An Giang provinces. In July-August 2013, the end-line survey, a cross-sectional study, was conducted. This issue shows several key findings of the end-line survey in comparison with the baseline survey conducted in 2011.
The Project’s Maternal & Child Health Handbook
Mothers’ attitude on pregnancy The aforementioned improvement of mothers’ knowledge is likely to change their attitude. It was found in the end-line survey that 81% of mothers take their MCHHBs when receiving ante-natal care at commune health centers (Figure 2). Though there are no baseline data for this indicator, because when the baseline data were collected, distribution of the MCHHBs had either not started or been completed in the target districts.
Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam Phone: +84-4-3736-8573, Fax: +84-4-3736-8574
Technical Brief: Issue 2 Behavior changes on antenatal care through the MCH Handbook
Knowledge Know danger sign during pregnancy
Attitude Bring the MCHHB to ANC visits
Practice Make at least 3 ANC visits and tetanus immunization
Process of Knowledge, Attitude and Practice (KAP)
Mothers’ practice on pregnancy The proportion of mothers who had at least three-time ANC visits and tetanus immunization increased (Figure 3). Though statistically significant difference was not detected, it was found the pregnant women’s motivation for ANC was increased through verbal guidance on the MCHHB they received from health workers. Thus, knowledge, attitude and practice (KAP) among mothers improved through distribution of the MCHHBs to pregnant women.
Value added of Maternal and Child Health Handbook The MCHHB covers a series of continuous care of maternal and child health at different stages: (i) pregnancy; (ii) delivery and birth; (iii) post natal; (iv) neonatal; (v) infancy; (vi) under-five childhood. It compiles records of growth monitoring chart for children and child immunization. The MCHHB features its unique function, i.e. both recoding part and guidance part. Pregnant women, mothers, husband other family members can learned at home without seeing health workers. By internally discussing maternal and child health topics among family members, caring mind for pregnant women, mothers and children are expected to increase.
Not only pregnant women and mothers but also health workers found the MCHHBs useful. One physician at a commune health center in Long Xuyen, An Giang province mentioned “This MCHHB is full of information about maternal and child health care. It is well-suited to the needs of health workers in managing health care for pregnant women, mothers and children”
An interview with a mother in a village in Dien Bien province
Further reading: VietHealth (2013) End-line survey for assessing the intervetnin of Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide. Hanoi: JICA Baequni and Nakamura Y. (2012), Is Maternal and Child health handbook effective?: Meta-analysis of the effect of MCH book, Journal of International Health .27 (2): .121-127.
Project for Implementing Maternal and Child Health Handbook for Scaling-Up Nationwide Rm 1.8, Bldg A, Hanoi School of Public Health, 138 Giang Vo street, Ba Dinh district, Hanoi, Vietnam Phone: +84-4-3736-8573, Fax: +84-4-3736-8574
