Impact of home-based records on child health outcomes in Lagos State. Evidence from the Nigerian Demographic Health Survey (NDHS)


Home-based records are used to document the progress of health services administered to an individual; It takes account of hospital visits, immunization and child development progress. In Nigeria, despite the high birth-rate and fertility, the use of home-based records is less than 50%. Effective utilization of home-based records has been found to improve health seeking behaviours, breast feeding and communication in high income countries. However, there is still a lack of reliable evidence to prove the value that results from the use of these records specifically in low- and middle-income countries. The 2018 guidelines for home-based records published by the World Health Organization emphasized that more research is required to verify the effectiveness of home-based records in improving MNCH outcomes. Although knowledge and coverage of immunization in Lagos state is higher than in other regions in Nigeria, recent figures from the NDHS show worsening rates of neonatal and under-5 mortality. As such it is important to investigate whether the use of immunization cards and other home-based records has significant effect on child hood outcomes. The NDHS is carried out in the 36 states of Nigeria with a sample size of 41,821 women of reproductive age. So far 10 surveys have been carried out between 1990 and 2018. This study would perform multivariate analysis on responses from the 2018 survey by extracting data collected from women in Lagos state. This would cover responses on the use of immunization cards and other home-based records and the corresponding effect this has on vaccination completion, birth weight, child, nutritional status. For triangulation, the study, might also benefit from a qualitative aspect, that would involve interviews and focus group discussions with women in public hospitals in Lagos state. This study would be in line with WHO recommendation, add to the scarce literature on the subject, and could potentially inform policy.


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