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Last updated: 2019 October 3
Home-based Record Repository


Welcome to this home-based record repository! Home-based records, as described below, provide an inexpensive yet effective mechanism for systematically recording the primary care services received by an individual in many countries. The purpose of this repository is to support the free and open exchange of information related to home-based record (HBR) content and design that ultimately may be useful to the improvement of health outcomes. It is with great appreciation that we extend words of humble gratitude to the many persons around the world in immunization programme offices, UNICEF and WHO country offices, among others who have taken the time to share the documents contained herein. We invite you to view the available home-based records by selecting from the country listing at left.


Note: If the information posted here is incorrect, please send an e-mail to info [at] brownconsultingroup [dot] org (to the attention of D Brown) with a short note explaining the error and supporting documentation. 


 

Home-based records: definition and function


A home-based record is a medical document—more often physical rather than electronic—issued by a health authority—such as a national, provincial, state or district health department—on which an individual’s history of primary healthcare services (e.g., vaccinations) received is recorded. In contrast to a facility-based record, the home-based record is maintained in the household by an individual or their caregiver.


Home-based records are an important component of immunization service delivery. When well-designed, available in adequate supply, widely adopted and appropriately utilized, home-based records (HBRs) complement facility-based records within routine health information systems by providing a standardized form for legibly recording an individual’s vaccination history in an organized and consistent manner for future reference and review (a wiki describing the home-based record in further detail can be found here). 


HBRs serve as an important information resource to enhance health professionals’ ability to make clinical decisions with the potential to enhance continuity of care and alleviate risks such as missed opportunities for delivering vaccination as well as unnecessarily re-vaccination that may be associated with absent or suboptimal documentation within health facilities. 


Importantly, HBRs also serve as a point of reference around which health care providers may start discussions with individuals or their caregivers and empower them to make informed decisions about their healthcare.


Finally, because HBRs serve as a source of documented evidence of an individual’s vaccination history, they play an important role beyond direct clinical care including within quality of care management and public health monitoring through vaccination coverage surveys.


Unfortunately, the HBR is too often unable to fulfil its intended purpose because:

  • the HBR is not available in the right place, at the right time and/or in the right quantity;
  • the HBR is not appropriately referenced, used and legibly completed by health care workers at the time of service; and/or
  • the HBR is not fully owned, valued and utilized by individuals or their caregivers as an important document.

We continue to understand the reasons that underlie these HBR system failures in order to identify corrective actions. We believe this site is an important part of that process, and we look forward to its continued improvement.

 


Countries are listed in the left sidebar in alphabetical order according to country name. Select a country to view available home-based vaccination records.  As of 28 November 2017, records are available here from 163 countries or territories, of which 156 are Member States of the World Health Assembly.


A tracking sheet highlighting the countries for which electronic and/or hard copies of home-based vaccination records are on file is available at http://bit.do/HBR-tracking. 



WHO Recommendations on Home-based Records for Maternal, Newborn and Child Health

In September 2018, WHO published recommendations on home-based records for maternal, newborn and child health. Related material can be downloaded here (http://www.who.int/maternal_child_adolescent/documents/home-based-records-guidelines). 

Two important recommendations from the document include:
  • The use of home-based records, as a complement to facility-based records, is recommended for the care of pregnant women, mothers, newborns and children, to improve care-seeking behaviours, male involvement and support in the household, maternal and child home care practices, infant and child feeding, and communication between health providers and women/caregivers. (Low-certainty evidence)
  • There was insufficient evidence available to determine if any specific type, format or design of home-based records is more effective. Policy-makers should involve stakeholders to discuss the important considerations with respect to type, content and implementation of home-based records.
The primary audience for the guideline is policy makers and health programme managers of MNCH and immunization programmes in ministries of health where decisions are made and policies created on the use and implementation of homebased records. Development and international agencies and non-governmental organizations that support the implementation of home-based records will also find the document useful.

Practical guide for the design, use and promotion of home-based records

The World Health Organization has produced a document that provides guidance to national immunization programmes on how to redesign home based records and promote their use among health workers and caregivers.

Practical guide for the design, use and promotion of home-based records in immunization programmes


Experiences from a workshop to revitalize home-based records

In March 2016, the UNICEF Regional Office for South Asia and the Bill and Melinda Gates Foundation organized a four-day workshop aimed at optimizing the quality, availability and use of HBRs through a collaborative south-south exchange of state and national officials, development partners, data experts and design professionals. The workshop included participants from Afghanistan, India, Nepal, and Pakistan as well as representatives from Sri Lanka, who shared positive experiences from their country’s HBR. The workshop provided a unique opportunity for country teams to delve deeply into the complexities and considerations of the HBR and generated interest and momentum to take action to improve how HBRs function in practice in each of the four distinct country contexts. A report from the workshop is linked here and a follow-on commentary can be obtained from here. There are plans to conduct a similar meeting in Africa in early 2017; results will be reported back here. Stay tuned!


What are home-based records called in your country?

Help us develop a thesaurus of terms used for home-based vaccination records around the world.


Visit http://bit.do/HBR-names


A listing of identified reference terms for home-based records can be found here.



Take a few moments to view a brief video from John Snow Inc (JSI) describing the roles and functions of home-based records.

JSI HBR Video






Home-based records are available here from 163 countries or territories* as of 28 November 2017




The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

* Of the 163 countries or territories, 156 are Member States of the World Health Assembly.


Related Postings from TechNet and elsewhere on the web.


Related reading material is noted below.


A website to track the prevalence of home-based vaccination records seen at the time of household survey can be found at: http://bit.do/HBR-prevalence.


Home-based record awareness images

      











 

Disclaimer: The findings and views expressed herein are those of the authors alone and do not necessarily reflect those of their respective institutions. All reasonable precautions have been taken to verify the information contained herein. However, the material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the site administrator or his employer be liable for damages arising from its use.