THE MATERNAL AND CHILD HEALTH HANDBOOK: A PILOT STUDY IN SIERRA LEONE

The Maternal and Child Health Handbook (MCHHB) is a home-based record designed to improve continuity of care across maternal,neonatal, and child health services. In Sierra Leone-where maternal, neonatal, infant, and under-five mortality remain high (443/100,000; 31/1000; 72/1000; 122/1000 - DHS 2019)-the Ministry of Health and Sanitation piloted the MCHHB from 2021-2022 in Moyamba, Pujehun, and Western Rural Districts. This baseline survey assessed client characteristics, health-seeking behaviour, and understanding of MCH information before full rollout. A mixed-methods approach used questionnaires and interviews in five intervention and two control facilities, targeting 500 clients (470 intervention; 76 control). Findings showed 41% were illiterate, 64% had their first pregnancy before 18 years, and 29% had multiple abortions or stillbirths. ANC knowledge and practices were higher among MCHHB users than controls (81% vs. 68% knew their next ANC date and purpose).