The use of the Road to Health Card in monitoring child health

Abstract

Background The Road to Health Card (RTHC) provides a simple, cheap, practical and convenient method of monitoring child health. The RTHC could assist in improving health through vaccine compliance and early identification of growth faltering. The purpose of this study was to assess whether the RTHCs are completed and interpreted adequately at primary, secondary and tertiary care levels in South Africa.

Methods The study was carried out at a primary, secondary and tertiary care centre. A questionnaire was administered to 100 subjects at each centre to obtain demographic information, information on whether the RTHC had been brought along and, if not, why it had not been brought.

Results Most children were brought to the centres by their mothers. The RTHC was not brought to 48% of the consultations; of these respondents, about 72% thought that bringing along the RTHC was not necessary. Health workers seldom asked to see the RTHC in the primary and secondary care settings, but 50% of them did so at Ga-Rankuwa Hospital (p = 0,002). In only eight cases overall were the children below the third percentile of weight for age. Approximately 20% had incomplete immunisations.

Conclusion Many parents believe that the RTHC is only required for visits to the Well-baby Clinics, and not for consultations. The RTHC is not often asked for at consultations; the fact that this is more often done at the tertiary care centre may be the result of the service being supplied by paediatricians-in-training. Health workers should ask to see the RTHC in order for mothers to understand the importance of the information contained in it. The study showed that the RTHC is not used to its full potential.

The situation in private general practice was not investigated, but is not expected to differ much from that described in this article. Although many family physicians do not offer immunisations as a service, they all deal with sick children and if the general practitioner asks mothers to produce the RTHC and then discusses its reference to her child's current problem, the mothers are more likely to understand the importance of the RTHC as a tool in monitoring child health.