Trial of MCH handbook in Cambodia: A home-based combined record for mothers and children

Backgrounds:The Maternal and Child Health (MCH) handbook is a home-based record of events from the prenatal period to infancy. In developing countries, the records have taken the form of cards aiming one purpose at a time. The uniqueness of the MCH handbook is that it combines information of mothers and children. Objectives:1) Describe the development of Cambodian version of MCH handbook and its field trial, 2) Evaluate impact of the MCH handbook on maternal knowledge and behavior. Methods: The study was conducted in two districts in Kampong Cham Province. The Cambodian version of the MCH handbook was developed and introduced into two health center catchment areas. Two other health centers were taken as control. To evaluate its impact on maternal knowledge and behavior, both qualitative and quantitative data were collected. Quantitative data were collected using questionnaires. Subjects were women who delivered babies during one year prior to the survey. We selected 320 women for intervention and 320 for control areas. Qualitative data were collected using focus group discussions with health professionals, mothers and health volunteers. Results: Antenatal care attendance, delivery with skilled birth attendants as well as hospital delivery were increased significantly more in the intervention than in the control areas. Maternal knowledge on danger signs during pregnancy and delivery was increased in the intervention areas as well as the control areas. However the increase was more remarkable in the intervention than in the control areas, showing the usefulness of the handbook as an education tool.