Field workers' records and a microcomputer: Monitoring child health in Nepal

Abstract

A district-level project for monitoring uptake of family planning, child health and immunization services was started in Sindhupalchok, Nepal, in 1983. The project entailed setting up skill-based in-service training for health workers and their supervisors, and organizing collection of data from field workers' routine reports at quarterly intervals after training. A microcomputer and dBase II software were used to analyse the data, producing reports for different management purposes. Data from each field worker area were aggregated and then analysed with respect to the number of occasions on which households were contacted successfully. Despite geographical variations in the availability of immunization facilities, the uptake of immunization was rapid in all areas covered. Family planning services were universally available in the project area. However, the increase in the percentage of couples practising family planning was more gradual. These results support the linkage between visible improvements in child health services (including home visiting) and uptake of family planning. Data on morbidity and nutritional status showed no overall improvements among any regularly-visited children within the first 2 years of the project. Although the training provided in the project was effective, and the information system was felt to be appropriate and useful, the quality of supervision of field workers in the government Mother and Child/Family Planning Division was not adequate to ensure follow-up and reporting in areas remote from the district centre. However the information yielded through the project does reveal the potential benefits of home visiting services for children's health in Nepal. The information also permits the setting of targets for achievements by field workers responsible for promoting child health in the hills of Nepal. © 1988 Oxford University Press.