Use of a child health surveillance instrument focusing on growth. A cross-sectional study

ABSTRACT BACKGROUND: Proper use of a child health handbook is an important indicator of the quality of care provided to children at healthcare services. This study aimed to evaluate the use of child health surveillance tool (by health professionals?), especially focusing on growth. DESIGN AND SETTING: Cross-sectional study carried out in the context of the Family Health Strategy in two municipalities in Paraíba, Brazil. METHODS: Three hundred and twenty-one children under five years of age from areas covered by health workers were included in the study. Mothers answered a questionnaire asking for information on sociodemographic characteristics. Growth charts, records of iron and vitamin A supplementation and notes on immunization schedules registered in the instrument were analyzed. In the case of children for whom the third version of the child health handbook was used, the association between completion of this handbook and sociodemographic characteristics was analyzed. RESULTS: All the parameters studied showed high frequencies of inadequate data entry, ranging from 41.1% for the weight-versus- age chart to 95.3% for the body mass index-versus-age chart. Higher frequency of inadequate data entry was found among children aged 25 months and over and among those living in areas of these municipalities with minimal numbers of professionals in the healthcare teams. CONCLUSIONS: The use of a child health handbook to monitor children’s growth in the municipalities studied appeared to be faulty. Data entry to this instrument was better at locations with larger healthcare teams.

研究背景：儿童健康手册（child health handbook）的规范使用，是医疗卫生服务机构为儿童提供照护质量的重要评价指标。本研究旨在评估儿童健康监测工具（child health surveillance tool，由医疗卫生专业人员使用？）的使用情况，重点聚焦儿童生长发育相关内容。
研究设计与实施场景：本研究为横断面研究，在巴西帕拉伊巴州（Paraíba）的两个市镇开展，研究纳入家庭健康策略（Family Health Strategy）的实施场景。
研究方法：本研究共纳入来自医疗卫生服务人员覆盖区域的321名5岁以下儿童。由儿童母亲填写问卷，收集社会人口学特征相关信息。对该手册中记录的生长曲线图表、铁剂与维生素A补充剂服用记录，以及免疫接种日程备忘内容进行分析。针对使用第三版儿童健康手册的儿童亚组，本研究进一步分析了手册完整填写情况与社会人口学特征之间的关联。
研究结果：所有研究涉及的参数均存在较高比例的数据录入不规范情况，录入不规范率范围从体重-年龄图表的41.1%，到体质指数（body mass index，BMI）-年龄图表的95.3%不等。数据录入不规范率更高的群体为25月龄及以上的儿童，以及居住在上述市镇医疗卫生团队专业人员配置不足区域的儿童。
研究结论：在所研究的两个市镇中，使用儿童健康手册开展儿童生长发育监测的工作存在明显疏漏。医疗卫生团队规模更大的区域，该手册的数据录入质量更高。