MoTeCH Field Report: Gaani, UER

Report of Observations for the Upper East Regional Health Administration

Gaani CHPS Zone

5^th August, 2009

 

By chance the health worker at Gaani CHPS Zone, Jennifer, was doing outreach for baby-weighing, so I had the opportunity to join. The main CHPS nurse was in town dropping off DHIMS records so they were short staffed. This meant that Jenny welcomed some help doing the registers for the 75 babies we weighed at that outreach session. It was great to experience first-hand the complexities of the current recording system.

 

Inconsistencies in Fields

There were inconsistencies in some of the fields. It’s important that MoTeCH takes note of these as they will likely affect phone-based registration systems for pregnant mothers and babies. We should think in particular of which fields, or combination of fields, we can use to locate an existing record or to identify duplicates.

-         Sometimes the baby name field was blank in the register (since families often prefer not to name their baby until they are a few weeks old).

-         Sometimes the name initially given to the baby had later been changed, so that different baby names appeared in the register versus the child’s record book.

-         It is common for people to have 3 or 4 different names, so different combinations of those names had been used in the register versus the record book – this applies both to baby’s and mother’s name.

-         Names have alternate spellings and mothers and health workers are usually not particular about pinning down a particular spelling, so often this differs in the register versus the record book.

-         Place name seemed to be spelt quite consistently (in Uganda it was common for a single place to have multiple accepted spellings. It’d be good to see if this applies here also).

 

Challenges in using the Register

Each child’s record book (kept by the parents) contained the child’s ‘serial number’ and ‘register number’, which was supposed to correspond to the equivalent fields in the register. The register was ordered according to register number, and using this field the health worker finds the baby’s entry in the register in order to enter the child’s weight result. In actual fact, there were quite a few discrepancies in this system – not surprising given the volume of information and complex manual system:

-         Sometimes the same serial number or register number had been allocated to more than one baby.

-        Sometimes the incorrect register or serial number had been written on the child’s record book.

-         In cases of the above you had to search for the child according to Date of Registration (ie the date when the baby was first brought for care), since the register was chronological.

-         There were 2 registers, one for babies aged 0-11 months, one for babies 12-23 months. The same register numbers are used in both registers (1,2,3,4…). So, before you can start searching for the baby’s entry in the register you have to determine the child’s age (using Date of Birth field in the child’s record book) to determine which register you should search in.

Because of all these factors it sometimes took quite some time to locate the baby’s entry in the register, adding to the time the nurse spent on paperwork, and detracting from her time attending to patients.