An assessment of the 'road-to-health' card based on perceptions of clinic staff and mothers.

Objectives: To describe the opinions of health personnel and parents at child health clinics in Cape Town; to determine the accuracy and completeness of data recorded on the present 'Road-to-Health' (RTH) card; and to ascertain the views of clinic staff and mothers regarding what information they would like to record.

Design: Descriptive prospective study.

Setting And Subjects: Qualitative interviews of 35 health personnel and 150 mothers/caregivers were conducted at 17 child health clinics. The clinic practices of 32 health personnel were monitored and details of 150 RTH cards were examined.

Main Outcome Measures: Responses of health personnel at public and private child health clinics and of mothers were analysed. Data recorded on the card were extracted under the headings: neonatal data, immunisation schedules, measurements, and weight-for-age chart.

Results: Most nurses supported the concept of an RTH card but a large majority recommended that it be replaced with a notebook retained by the mother. A significant proportion of health personnel did not know how to use the weight-for-age chart. Most mothers attending clinics carried the card, but this number dropped for hospital visits and consultations with private doctors. Mothers' understanding of the card was limited. For mothers the weight-for-age chart, immunisation schedule and milestone section are obscure.

Conclusion: Health personnel and mothers would like to replace the RTH card with a notebook in the parents' home language. It should contain more information on health matters, adequate space to record weight and infectious diseases, an illustrated milestone chart and an improved schedule for immunisations. Mothers perceived the RTH card as belonging to the clinic and wanted a 'baby's own' document.