ArticleJournal of global health2026
Association between the ownership of home-based records and continuous, quality maternal and child health service utilisation: a multi-country analysis of Demographic Health Surveys from 18 low- and middle-income countries.
Article in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The continuity and quality of maternal and child health (MCH) services represent significant challenges in low- and middle-income countries (LMICs). Home-based records (HBRs), including the integrated Maternal and Child Health Handbook (MCHHB), may support consistent service usage and improved care quality. We aimed to evaluate the association between HBRs and continued quality MCH care, identifying differences in associations between MCHHBs and the continuum of care and those between other HBR types and the continuum of care. Methods: We conducted a pooled analysis of Demographic and Health Surveys (DHS) from 18 LMICs, including women and their youngest eligible children for the health card module. We defined the continuum of quality MCH care using receipt of quality antenatal care (ANC), skilled birth attendance, and quality postnatal care (qPNC), with ANC and PNC measured as composite indicators. We based the HBR ownership on the DHS variable 'Has health card'. We used multivariable logistic regressions to examine associations between HBR ownership, HBR type, and the continuum of care, adjusting for residence, maternal education, and wealth. Results: The final analysis included 89 902 samples. Ownership of HBR was associated with significantly higher odds of completing the continuum of quality MCH care compared with not owning HBR. However, no significant differences were observed between owners of MCHHB and those of other HBR types. Based on analysing the subgroups of MCH service components, the MCHHB may facilitate the provision of ANC services, such as urine and blood tests, more effectively than other HBR types. Conclusions: Owning HBR was positively associated with greater use of quality MCH services. However, no significant differences were observed for MCHHBs, despite MCHHB ownership being significantly associated with improved uptakes of urine and blood tests. Further research is needed to explore the influence of actual HBR use, provider-related factors, and variations in HBR content and type.
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