Usefulness of parent-held child health records in low, middle, and high-income countries: a systematic review and meta-analysis

Parent-held child health record (PHCHR),a means of promoting access to preventive health services has been in use for decades in many high-income countries and a growing number of low- & middle-income countries (LMIC). This study aimed to systematically review the usefulness of the record toward promoting children health and development. PubMed, PsycINFO, CINAHL, Cochrane Library and Google Scholar were searched to identify relevant articles, using a pre-defined set of inclusion/exclusion criteria. Findings were narratively synthesised due to considerable heterogeneity. Outcomes with sufficient data were meta-analysed using a random-effects model. Odds Ratio (OR) was used to compute the pooled effect sizes at 95% confidence interval (CI). Thirty-two (32) studies met the inclusion criteria, which reported findings from 15399 parents. Generally, parents (average-72%) perceived the PHCHR as useful/important for child care and majority (average-84%) took it to child clinics.Health visitors (average-93%) and nurses/midwives (average-70%) were reported as more likely to use/refer to the record than hospital doctors (average-31.2%). The pooled effect of the PHCHR on utilisation of child/maternal healthcare was not statistically significant (OR = 1.31, 95% CI 0.92–1.88). However, parents who use the record in LMIC were approximately twice as likely to adhere to child vaccinations (OR = 1.93, 95% CI 1.01–3.70), utilise antenatal care (OR = 1.60, 95% CI 1.23–2.08), and better breastfeeding practice (OR = 2.82, 95% CI 1.02–7.82). It is concluded that parents generally valued the PHCHR, but its usefulness with child health-related outcomes have only been demonstrated in LMIC.