Leeds Health Education Effectiveness Database

Listing of papers reviewed but excluded from the database

Sarah Hubley, January 2008

Summary of reasons for exclusion of topics from Leeds Health Education Database

Listing of papers reviewed and not included in database

1.       Aids and sexually transmitted diseases

2.        Family planning and population education

3.        Maternal and Child Health

4.        Childbirth/safe motherhood

5.        Breast feeding promotion

6.        Oral rehydration therapy and the management of diarrhoea

7.        Immunization uptake

8.        Acute respiratory infections

9.        Growth monitoring

10.     Nutrition education

11.     Control of Infectious diseases including tropical and parasitic diseases -Onchocerciasis, dengue fever control, Chagas Disease, Filariasis, Guinea worm control, Hookworm, Malaria, Schistosomiasis, Leprosy , Tuberculosis

12.     Oral/dental health promotion

13.     Eye health and the prevention of blindness

14.     Environmental health including water, sanitation and hygiene education

15.     Chronic diseases, substance abuse and mental health

16.     Miscellaneous health topics, including primary health care, patient education, accident prevention/safety education

Introduction

The development of the Leeds database involved searching the literature for papers that appeared from their titles/abstracts to be evaluations of health communication interventions. 600 items were identified and reviewed for suitability for inclusion using the following criteria:

The health education/health communication should be described
There should be evidence of impact of the health communication on the community.
There should be evidence to attribute the impact achieved to the health education/communication activity either through the use of controls or other means.
Data can be quantitative or qualitative - in both cases adequate information should be provided on the evaluation methodology including sampling, data collection and data-analysis/statistical testing.
The intervention should take place in a developing country
The report should be in a published or easily accessible source and be dated after 1975.

Details are provided in this document of the 266 publications that did not meet these criteria and were not included. The papers are presented in alphabetical order with a brief summary of the reasons for exclusion.

A summary of some of the main reasons for exclusion is provided at the beginning of this listing. The non-inclusion of a report should not be interpreted as a criticism of the authors. In some cases the purpose of the paper was not to present an evaluation of health education intervention. There are many reasons why published reports fail to provide adequate information. The vehicle used for publishing may not have provided adequate editorial support or allowed the authors to present data. Some publications are newsletters designed for decision-makers or field workers and mistakenly believe that they should keep articles simple and not include evidence to support claims made for impact. Not everyone has the language ability, academic skills or time to prepare a report with adequate description and evidence. Funds might not have been provided by donors for adequate data-collection, evaluation and preparation and dissemination of reports. It is hoped that one of the outcomes of the Leeds Health Education Database will be the development of guidelines for donors, investigators, journals on the design, evaluation and reporting on health communication interventions in order to develop publications that enrich the evidence-base for health education in developing countries.

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Summary of reasons for exclusion of items from the Leeds Health Education Database

General

The health education is not adequately described with no description of the methods used, personnel involved or the content
Health education was only one of many components of a programme and no attempt is made to ascribe the impact achieved to the health education component.
The report is a descriptive study of activities with no data on impact - the term process valuation is incorrectly used
The authors have carried out a cross-sectional/KAP study of a community and used it to infer the impact of existing health education but have not linked the study to health education components
The performance of the health education evaluated (e.g.an observational study of the communication by the health worker, the content of a drama) but the impact on the community is not measured
While using the term evaluation - the study is more correctly a pre-test of an intervention
The intervention is evaluated in terms of performance of the health worker e.g. improved prescribing practices, referral, treatment, communication skill and not impact on the community
The purpose of the study is primarily an epidemiological one - to establish the link between a practice e.g. handwashing and health outcomes. Thus the study does not investigate methods for promoting the health practice in the community.
The outcome measures are not properly defined (e.g. a knowledge scale is used without adequate definition of the knowledge measured)
The outcomes are ethically unacceptable (e.g. to 'abstain from homosexuality' or not to marry)
Inappropriate objectives - e.g. increase in protein foods

Data collection/analysis/presentation

Lack of detail of sampling/use of self-selected samples
Lack of information on data-collection instruments
Data reported as % but raw data no provided
Lack of statistical treatment and significance tests to justify assumptions
No base line data provided or alternative means to demonstrate that there has been an impact
No controls or alternative methods for ascribing the impact to the intervention
Findings of qualitative studies presented with no accompanying description of method used for analysis of data

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1. AIDS, Sexually transmitted diseases

Asthana,S. and Oostvogels,R. (1996) Community Participation in HIV Prevention: Problems and Prospects for Community-Based Strategies among Female Sex Workers in Madras. Social Science and Medicine 43, 133-148.
Notes: Note that this is a very interesting account of the organization of CSWs in Madras and provides a particularly detailed account of the development of a peer education programme. However, while containing reflection and useful discussion , no evaluation was carried out. The authors refer to a qualitative evaluation but do not provide any discussion of any analysis of this in a rigorous way. As such it does not really meet the criteria for the Leeds Health Education Data-base either through a quantitative or process evaluation - a great disappointment as it is a very interesting account

Cameron,K.A., Witte,K., Lapinski,M.K. and Nzyuko,S. (1998) Preventing HIV transmission along the Trans-Africa Highway in Kenya: using persuasive message theory in formative education. International Quarterly of Community Health Education 18, 331-356.
Notes: Despite the use of the word formative evaluation in the abstract, this is really a research study of a target group and not an evaluation of an intervention. It is therefore not considered suitable for the Leeds Health Education Database

Capoor,I. and Mehta,S. (1995) Talking about love and sex in adolescent health fairs in India. Reproductive Health Matters 22-27.
Notes: This is an interesting programme but does not contain data on impact

Chikwem,J.O., Ola,T.O., Gashau,W., Chikwem,S.D., Bajami,M. and Mambula,S. (1988) Impact of health education on prostitutes' awareness and attitudes to acquired immune deficiency syndrome (AIDS). Public Health 102, 439-445.
Notes: Minimal information is provided on the health education activity, there is no baseline and a control. The report has been rejected from the Leeds Health Education Database

Dick,B. (1992) A tale of two programmes--a health education success story from the International Federation of Red Cross and Red Crescent Societies. Hygie 11, 53-58.
Notes: This is a descriptive study with no impact data.

Evian,C.R., Ijsselmuiden,C.B., Padayachee,G.N. and Hurwitz,H.S. (1990) Qualitative evaluation of an AIDS health education poster. A rapid assessment method for health education materials. S. Afr. Med. J. 78, 517-520.
Notes: This is an example of pre-testing and not an evaluation of impact.

Foster,G. (1990) Raising AIDS awareness through community mobilization. Trop. Doct. 20, 68-70.
Notes: While providing a useful description of a counseling programme, this study does not provide any impact data on the community. It is therefore considered not suitable for the Leeds Health Education Database.

Frank,M. (1996) Theatre in the service of health education: case studies from Uganda. New Theatre Quarterly 12, 108-115.
Notes: The paper is a discussion of the content of the plays and presents no information on the impact of the plays on the audience.

Hangzo,C., Chatterjee,A., Sarkar,S., Zomi,G.T., Deb,B.C. and Abdul-Quader,A.S. (1997) Reaching out beyond the hills: HIV prevention among injecting drug users in Manipur, India. Addiction 92, 813-820.
Notes: While providing a detailed description of a programme for reaching injecting drug users, there is no information on impact on the target group.

Helquist,M. and Sealy,G. (1991) One of our Sons is Missing: using theatre to confront sensitive issues. In: World Health Organization and Royal Tropical Institute, (Eds.) AIDS prevention through health promotion: facing sensitive issues, pp. 39-41. Amsterdam: Royal Tropical Institute [KIT].]
Notes: An interesting account but mainly descriptive of the drama with no impact data.

Kinsman,J., Harrison,S., Kengeya-Kayondo,J., Kanyesigye,E., Musoke,S. and Whitworth,J. (1999) Implementation of a comprehensive AIDS education programme for schools in Masaka District, Uganda. AIDS Care 11, 591-601.
Notes: This represents a very thoughtful discussion of the problems of implementation of health education on AIDS with schools in Uganda. Impact data is not presented and the evaluation of the programme mainly draws on insights of the programme organizers and feedback from teachers. While it has been considered unsuitable for the Leeds HE Database - it is a valuable document for the insights provided.

Laver,S.M., Van den Borne,B., Kok,G. and Woelk,G. (1996) Was the Intervention Implemented as Intended?: A Process Evaluation of an AIDS Prevention Intervention in Rural Zimbabwe. International Quarterly of Community Health Education 16, 25-46.
Notes: This study claims to show that merely using quantitative data on its own can be misleading and a case is made for using the process evaluation method. Where there is good descriptive account of a farm worker health intervention, it is disappointing that no information is provided of the quantitative study and raw data is not shown from either the quantitative evaluation, qualitative evaluation or the process evaluation. The report does not provide sufficient detail of the process evaluation to warrant entry into the Leeds Health Education Database

Lyttleton,C. (1994) Knowledge and meaning: the AIDS education campaign in rural Northeast Thailand. Social Science and Medicine 38, 135-146.
Notes: This report provides a very interesting account of the processes affecting community perceptions of HIV/AIDS. However, insufficient detail is provided to make this an evaluation of the Thai AIDS education programme .

Lyttleton,C. (1996) Messages of distinction: the HIV/AIDS media campaign in Thailand. Medical Anthropology 16, 363-389.
Notes: Represents a discourse analysis of the content of AIDS education and does not include any impact data.

Muller,O., Lubega,J. and Senoga,J. (1989) Impact of the AIDS-education programme on Ugandan Schoolchildren. AIDS Care 1, 135-136.
Notes: This has been removed from intervention data-base as it is mainly a descriptive account of a poster competition with no impact data

Nath,M.B. (2000) Women's health and HIV: experience from a sex worker's project in Calcutta. Gender and Development 8, 100-108.
Notes: This provides a fascinating account of a programme of mobilizing sex workers in Calcutta. While a detailed account of the programme is provided, there has been no systematic attempt to gather any data to evaluate the programme. At some future date it would be appropriate to review the status of this paper as an example of process evaluation.

Ndeki,S.S., Klepp,K.I., Seha,A.M. and Leshabari,M.T. (1994) Exposure to HIV/AIDS information, AIDS knowledge, perceived risk and attitudes toward people with AIDS among primary school- children in northern Tanzania. AIDS Care 6, 183-191.
Notes: This has been removed from intervention database because it is a cross-sectional study and not an evaluation of an intervention

Obetsebi-Lamptey,J. (1991) Influencing decision-makers through video: experience in Ghana. In: Anonymous AIDS prevention through health promotion: facing sensitive issues, pp. 74-78. Geneva, Amsterdam: World Health Organization [WHO], Royal Tropical Institute]
Notes: Despite being one of the rare examples of a description of a programme for advocacy, the lack of detailed information on the impact of the activities limits the value of the report.

Peterson,C. and Szterenfeld,C. (1992) Organizing a project with community-based health agents recruited from prostitutes in Rio de Janeiro. Public Health 106, 217-223.
Notes: This is a description of an on-going programme and does not present any data on impact.

Ramasoota,T. (1991) Four years follow-up of the impact of AIDS and intensive health education on the control of sexually transmitted diseases in Thailand. Southeast Asian J. Trop. Med. Public Health 22, 489-498.
Notes: This report relies on data collected from other sources that are not described. Heavy use is made of STD clinic attendance data, the meanings of which are not clear. There are no controls or baseline. Little information is provided of the national health education activities and it is not possible to attribute programme impact to the national programme.

Rao,A.V., Swaminathan,R., Baskaran,S., Belinda,C., Andal,G. and Saleem,K. (1991) Behaviour change in HIV infected subjects following health education. Indian J. Med. Res. 93, 345-349.
Notes: The inappropriateness of advice (abstain from homosexuality, not marrying), lack of sensitivity to informed choice and the negative language makes this study an example of an ethically unacceptable victim-blaming approach

Rathore,A.S., Misra,R.S. and Ramesh,V. (1997) Domiciliary health counselling in patients with sexually transmitted diseases. J. Commun. Dis. 29, 35-39.
Notes: This paper provides a good description of the formidable problems in contacting STD patients in community settings. However, the field worker only managed to provide domiciliary counseling to 11 out of 169 defaulters. The attendance of sexual contacts in the previous year during the same period is used as a control which is not comparable. While providing valuable insights into problems of ensuring follow-up and contact tracing, this is not considered a suitable intervention for inclusion into the Leeds Health Education Database.

Ratnam,K.V. (1990) Efficacy of health education programme on awareness of AIDS among transsexuals. Singapore Medical Journal. 31, 33-37.
Notes: Note that awareness of AIDS was measured at the very trivial level and it is not clear what was meant by the rather vague term sexual practices. There is an error in the figures presented in table II. Given these uncertainties and the lack of controls this intervention should be removed from Leeds Health Education Database.

Rugpao,S., Sirichotiyakul,S., Yutabootr,Y., Saba,J., Prasertwitayakij,W., Natpratan,C., Tovanabutra,S., Wongworapat,K., Suwankiti,S. and Wanapirak,C. (1997) Sexually transmitted disease prevalence in brothel-based commercial sex workers in Chiang Mai, Thailand: impact of the condom use campaign. Journal of the Medical Association of Thailand 80, 426-430.
Notes: This was not considered relevant for the intervention database. Despite the title - details of the condom programme are not given. The study is a survey of prostitutes with no details of their exposure to the condom programme.

Sipan,C.L., Hovell,M.F., Blumberg,E.J., Hinrichsen,S.L. and Dubeux,C.R. (1996) Regional Training in AIDS Prevention for Health and Behavioural Science Leaders in North-Eastern Brazil. AIDS Care 8, 71-84.
Notes: This evaluation only measures impact on health workers and not on the community. Furthermore the only change measured is that of knowledge.

Soon,T., Chan,R.K. and Goh,C.L. (1995) Project youth inform--a school-based sexually transmitted disease/acquired immune deficiency syndrome education programme. Annals of the Academy of Medicine Singapore 24; 541-546.
Notes: Note- there was no measure of outcome/ no impact data. the programme was evaluated in terms of reported comprehension and whether they claimed to fine it useful.

Turner,R. (1994) Sex education gains strength in Mexican public schools. International Family Planning Perspectives 20, 73-74.
Notes: This is a unique intervention in that it seemed to have an impact on policy. Unfortunately it is only a short descriptive account which gives no data from the evaluations that are claimed to have been carried out.

Witte,K., Cameron,K.A., Lapinski,M.K. and Nzyuko,S. (1998) A theoretically based evaluation of HIV/AIDS prevention campaigns along the trans-Africa Highway in Kenya. Journal of Health Communication 3, 345-363.
Notes: Note - despite the use of the term evaluation in the title, this paper is essentially a pre-test of materials with no impact data.

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2. Family planning including sex education

Barzgar,M.A., Sheikh,M.R. and Bile,M.K. (1997) Female health workers boost primary care. World Health Forum 18, 202-210.
Notes: Lack of information on sampling and data collection, no significance testing, no controls.

Belcher,D.W., Nicholas,D.D., Ofosu-Amaah,S. and Wurapa,F.K. (1978) A mass immunization campaign in rural Ghana - factors affecting participation. Public Health Reports 93, 170-176.
Notes: No controls and no baseline and a lack of supporting information to infer contribution of programme.

deCastro,M.P., Mastrorocco,D.A., deCastro,B.M. and Mumford,S.D. (1984) An innovative vasectomy program in Sao Paulo, Brazil. International Family Planning Perspectives 10, 125-130.
Notes: No details are provided of the outreach activities of the programme and the study is an evaluation of the characteristics of the vasectomy patients of the clinic. Although information was obtained on motivations for coming for vasectomy the study did not provide any information on the role of the outreach programme in promoting uptake of services.

de Weiss,S.P., Loving,R.D., Palos,P.A. and David,H.P. (1990) Effect of sex education on the sexual and contraceptive practices of female teenagers in Mexico City. Journal of Psychology and Human Sexuality 3, 71-93.
Notes: Note this is a not an evaluation of an intervention but a cross sectional study which attempts to explore associations between reported attendance for sex education and behaviour. There are no controls.

El-Bushra,J. and Perl,S. (1982) Nigeria - my brother's children. Use of traditional Yoruba opera. In: Anonymous Family planning education in action, London: International Extension College/International Planned Parenthood Federation]
Notes: The main target group for the film was stated to be the newly emerging relatively more prosperous urban dweller, yet the evaluation was done with a rural community. Also no details are provided of the actual drama sessions and whether there were any accompanying talks/publicity materials. Details of the process for production of the drama were sketchy and it is not clear whether any pre-testing was done

Green,L.W., Fisher,A., Amin,R. and Shafiullah,A.B. (1975) Paths to the adoption of family planning: a time-lagged correlation analysis of the Dacca family planning experiment. International Journal of Health Education 18, 85-96.
Notes: This is a re-analysis of data plus some supplementary data collection to evaluate a programme originally reported in 1973. It has been excluded from the Leeds Database on account of the study being dated 1975 or earlier.

Khan,M.E. and Patel,B.C. (1993) Generating demand for contraceptives in India: a case study of IEC activities in Uttar Pradesh. International Quarterly of Community Health Education 13, 151-161.
Notes: This is a literature review and does not present any information on impact.

Kim,Y.M., Marangwanda,C. and Kols,A. (1997) Quality of counselling of young clients in Zimbabwe. East African Medical Journal 74, 514-518.
Notes: This is an interesting discussion of the practical problems of improving counseling for young people in a developing country. While it is based on an observational study of counseling sessions, it does not represent an evaluation of the counseling because there is no attempt to measure impact on the young person.

Lesotho Distance Teaching Centre (1980) Education for family planning in Lesotho - evaluation of the project, Maseru, Lesotho: Lesotho Distance Teaching Centre.
Notes: An interesting example of the benefits that come from a simple survey following a programme with some practical recommendations. Lack of baseline data makes this not a strong evaluation study

Lieberman,S.S., Gillespie,R. and Loghmani,M. (1973) The Isfahan communication project. Stud. Fam. Plann. 4, 73-100.
Notes: This is a detailed and useful report despite its lack of significance testing on the results. The main reason for exclusion from the Leeds Health Education Database is the data of publication of 1973 which is before the cutoff data.

Neumann,A.K., Ward,W.B., Pappoe,M.E. and Boyd,D.L. (1976) Education and evaluation in an integrated MCH/FP project in rural Ghana: the Danfa Project. International Journal of Health Education 19, 3-14.
Notes: Note - this paper only sets out an evaluation framework and does not include any data on actual impact of the programme.

Nosseir,N.K., McCarthy,J., Gillespie,D.G. and Shah,F. (1986) Using mini-surveys to evaluate community health programmes. Health Policy and Planning 1, 67-74.
Notes: While providing a good example of an action-research approach this study has limitations as an evaluation of impact. There was no baseline. There was no statistical comparisons between the different groups and in any case significance tests would have limited validity since the approaches were tried sequentially so it would be inappropriate to treat the survey populations as equivalent for comparison purposes.

Okediji,F.O. and Ogionwo,W. (1973) Experiment in population education and attitude change - an evaluation of the film "My Brother's Children" in two rural Nigerian communities, London and Lagos: Africa Regional Council of the International Planned Parenthood Federation and the Family Planning Council of Nigeria.
Notes: This is the full report of the evaluation of this film which has also been published as a Chapter in Family planning education in action - some community-centred approaches (ref id. 932). This reference falls outside the time criteria for inclusion in the database.

Olaleye,D.O. and Bankole,A. (1994) The impact of mass media family planning promotion on contraceptive behavior of women in Ghana. Population Research and Policy Review 13, 161-171.
Notes: This is a cross sectional analysis of a population in which contraceptive use was correlated against whether they reported to have seen some information on contraception on the mass media. Specific information was not obtained to link this reported recall to specific mass media programmes. It is not possible to infer a causal relationship from the data. There are no controls.

Reid,J. (1983) Educating mothers: how effective are MCH clinics? P. N. G. Med. J. 26, 25-28.
Notes: This is a practical and worthwhile evaluation of the amount of health education, however it did not provide information on the quality of the advice provided or of the impact on the mother's subsequent practice.

Reis,T., Elder,J., Satoto, Kodyat,B.A. and Palmer,A. (1991) An examination of the performance and motivation of Indonesian village health volunteers. International Quarterly of Community Health Education 11, 19-27.
Notes: This is a study of the performance of village health workers and does not contain any information in impact on the community.

Richter,H. (1988) An evaluation study of a health education programme for rural women in Bangladesh. Community Development Journal 23, 51-55.
Notes: Details of the sample sizes, data-collection instruments, impact are not presented.

Sakondhavat,C., Kanato,M., Leungtongkum,P. and Kuchaisit,C. (1988) KAP on Sex, Reproduction and Contraception in Thai teenagers. Journal of the Medical Association of Thailand 71, 649-653.
Notes: This is a weak study with inadequate details provided either of the educational intervention or of the timing of data collection/significance of results.

Sandhu,S.K., Gupta,Y.P., Srivastava,V.P. and Gupta,G.C. (1977) Adoption of modern health and family planning practices in a rural community of India. International Journal of Health Education 20, 240-247.
Notes: This represents a cross-sectional study of a community to determine what factors are associated with adoption of specific health practices. As such it is not an evaluation of an intervention. Minimal details are provided of the factors that are investigated so the implications for the role of specific interventions are minimal.

Starosta,W.J. (1994) Communication and family planning campaign: an Indian experience. In: Moemeka,A.A., (Ed.) Communicating for development - a new pan disciplinary perspective, pp. 244-260. Albany: New York State Press]
Notes: This is a cross sectional survey of 196 persons to explore attitudes to contraception. While it was carried out at the height of the Indian family planning campaigns, there is no data on exposure to/perceptions of the campaign so the data collected does not serve as an evaluation of the Indian campaign. There are no controls.

Ward,W.B., Neumann,A.K. and Pappoe,M.E. (1981) Community health project in rural Ghana: the Danfa Project--an assessment of accomplishments. International Quarterly of Community Health Education 2, 143-155.
Notes: Lack of information on measuring instruments.

Valente.T.W., Paredes,P. and Poppe,P.R. (1988) Matching the message to the process: the relative ordering of knowledge, attitudes, and practices in behavior change research. Human Communication Research 24, 366-385
Notes: This is an attempt to test various models of behaviour change (mostly variants on KAP). While providing a useful discussion of theories o behaviour change applied to family planning, It is not an evaluation of a specific programme. There are no controls.

Yeboah-Afari,A. (1986) Ghana daddies club together. People 13, 21-22.
Notes: Given the importance now being given to men's involvement in health care it is disappointing that so little information is provided of this intervention and its impact on the participating men.

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3. Maternal and Child Health

Elder,J. and Salgado,R. (1988) The well-baby lottery: motivational procedures for increasing attendance at maternal and child health clinics. Int. J. Health Serv. 18, 165-171.
Notes: This is a somewhat confused evaluation in that it might equally be inferred from the data that the main factor influencing uptake of services was the loudspeaker system on the vehicle (that broke down) or the mothers' awareness that vaccines were present at the clinic. However, the authors are honest about the limitations of the study and the paper gives a fascinating insight into the difficulties of achieving change in rural communities.

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4 Safe motherhood/pregnancy and childbirth

Alcalay,R., Ghee,A. and Scrimshaw,S. (1993) Designing prenatal care messages for low-income Mexican women. Public Health Rep. 108, 354-362.
Notes: This provides a very good description of the application of ethnographic research and theory to the development of an intervention but does not report on the intervention itself.

Etuk,S.J. and Asuquo,E.E. (2000) Effects of community and health facility interventions on postpartum hemorrhage. International Journal of Gynecology and Obstetrics 70, 381-383.
Notes: The impact data that is presented for the blood donation campaign was the number of cases of post-partum haemmorhage for which blood could be supplied. This would appear a very indirect measure compared to that of number of units donated voluntarily. Furthermore there were no controls.

Kandeh,H.B., Leigh,B., Kanu,M.S., Kuteh,M., Bangura,J. and Seisay,A.L. (1997) Community motivators promote use of emergency obstetric services in rural Sierra Leone. International Journal of Gynecology and Obstetrics. 59, S209-S218
Notes: The evaluation of this was in terms of referrals. It is not clear whether these are self referrals or the actual women deciding to present themselves for delivery. As such the study has not been included in the Leeds health education effectiveness data-base.

Langer,A., Victora,C., Victora,M., Barros,F., Farnot,U., Belizan,J. and Villar,J. (1993) The Latin American trial of psychosocial support during pregnancy: a social intervention evaluated through an experimental design. Social Science and Medicine 36, 495-507.
Notes: Division of Research on Woman and Child's Health, Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico
This is a useful review of methodology used in the Latin American Programme but it does not contain impact data (which are provided by the 2 papers from the same study in the database)

Nwakoby,B., Akpala,C., Nwagbo,D., Onah,B., Okeke,V., Chukudebelu,W., Ikeme,A., Okaro,J., Egbuciem,P. and Ikeagu,A. (1997) Community contact persons promote utilization of obstetric services, Anambra State, Nigeria. International Journal of Gynecology and Obstetrics. 59 Suppl 2:S219-24, S219-24.
Notes: Evaluation of this was through referral by health care staff and not impact on community behaviour change.

Olaniran,N., Offiong,S., Ottong,J., Asuquo,E. and Duke,F. (1997) Mobilizing the community to utilize obstetric services, Cross River State, Nigeria. International Journal of Gynecology and Obstetrics. 59, S181-S189
Notes: This study did not use controls. A baseline study of sample size 1849. A post intervention survey is referred to in the methods section but no information is provided of sampling. Data from a post intervention survey is presented in Table 2 and appears to show increases in awareness of obstetric complications - however the sample size for the follow-up study is only 200 and no significance testing has been carried out.

Opoku,S.A., Kyei Faried,S., Twum,S., Djan,J.O., Browne,E.N. and Bonney,J. (1997) Community education to improve utilization of emergency obstetric services in Ghana. International Journal of Gynecology and Obstetrics. 59 Suppl 2:S201-7, S201-7.
Notes: This study lacks any statistical evaluation or provides any evidence why the uptake of service increased or the role of the health education component. There are no controls

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5. Breast feeding promotion

Bentley,M.E., Dickin,K.L., Mebrahtu,S., Kayode,B., Oni,G.A., Verzosa,C.C., Brown,K.H. and Idowu,J.R. (1991) Development of a nutritionally adequate and culturally appropriate weaning food in Kwara State, Nigeria: an interdisciplinary approach. Social Science and Medicine 33, 1103-1111.
Notes: The emphasis of this paper is on the process of developing the weaning food and the nutrition education component is not described

Bradley,J.E. and Meme,J. (1992) Breastfeeding promotion in Kenya: changes in health worker knowledge, attitudes and practices, 1982-89. J. Trop. Pediatr. 38, 228-234.
Notes: This is a study of health worker understanding of breastfeeding and not an evaluation of a community programme.

Cardaci,D. (1994) Health education programme with female workers at a Mexican university. Promotion and Education 1, 5-9.
Notes: A descriptive account with no impact data

Cunningham,W.E. and Segree,W. (1990) Breast feeding promotion in an urban and a rural Jamaican hospital. Social Science and Medicine 30, 341-348.
Notes: While the data collection is supposed to be a cross sectional survey of 113 mothers and participant observation, the reporting of the findings is at an anecdotal level with a brief description of the presence or lack of breast feeding promotion at different stages in pre- and post- natal care. Little data is presented and there has been no systematic analysis of the alleged participant observation process. There are no controls.

Esamai,F. and Songa,J. (1994) Health education on breast feeding in antenatal clinics in Eldoret District Hospital, Kenya. East African Medical Journal 71, 149-154.
Notes: While claiming to be an evaluation of breastfeeding education, it really is a KAP study of mothers. Little information is provided of the educational programme on breastfeeding and, while revealing inadequate knowledge on the part of the mothers, the reasons for this have not been clearly elucidated by the study.

Haider,S.J., Al-Hamly,M., Barakat,A., Elder,J.P. and Roberts,A.H. (1993) Interpersonal education by rural Yemeni women for promoting child survival and maternal health. International Quarterly of Community Health Education 13, 119-125.
Notes: This is only a preliminary evaluation and, in the absence of numbers of mothers contacted and statistical evaluation of their responses this evaluation is not adequate to demonstrate an impact

Miller,L.C., Jami-Imam,F., Timouri,M. and Wijnker,J. (1995) Trained traditional birth attendants as educators of refugee mothers. World Health Forum 16, 151-156.
Notes: Details of data collection not provided, raw data not given, no significance tests on differences between controls and test groups, no baseline.

Musaiger,A.O. (1998) Evaluation of a nutrition education program in Oman: a case study. International Quarterly of Community Health Education 17, 57-64.
Notes: The evaluation of this programme is mainly in terms of coverage with a rather vague question about whether they practices the advice given. A very inadequate evaluation

Nakao,R.M. (1988) Effects of an education program on the health and illness profile of rural breast-fed babies. Philippine Journal of Nursing 58, 12-18.
Notes: Note that this citation in medline is incorrect - there is no article corresponding to this paper in that issue. Until the correct paper can be examined this intervention cannot be considered for the Leeds Health Education Database . See paper by same author published in 1992 that is in the data-base.

Obi,J.O. and Osuhor,P.C. (1984) The influence of health education on breast feeding practices in Benin City, Nigeria. Public Health 98, 84-88.
Notes: Lack of information on the health education component of the intervention and no controls.

Odumosu,M.O. (1982) The response of mothers to health education and the incidence of gastro-enteritis among their babies in Ile-Ife, Nigeria. Social Science and Medicine 16, 1353-1360.
Notes: Lack of controls severely limits the usefulness of this study in the absence of any other data for inferring causality. No consideration of seasonal effects on diarrhoea. This has led to its rejection from the Leeds database.

Riveron Corteguera,R.L. (1995) Strategies and causes of reduced infant and young child diarrheal disease mortality in Cuba, 1962-1993 [see comments]. Bull. Pan. Am. Health. Organ. 29, 70-80.
Notes: Department of Pediatrics, Gral Calixto Garcia Faculty, Superior Institute of Medical Sciences, Havana, Cuba. While valuable as a review of a large scale national programme, there is insufficient information presented to link declines in diarrhoea rates with programme inputs.

Rodriguez-Garcia,R., Aumack,K.J. and Ramos,A. (1990) A community-based approach to the promotion of breastfeeding in Mexico. Journal of Obstetric, Gynecologic, and Neonatal Nursing 19, 431-438.
Notes: The lack of information on the data collection methods, raw data and significance testing seriously limits the value of this report.

Tamagond,B. and Saroja,K. (1991) Reasons for not feeding colostrum and effectiveness of an educational programme for promotion of colostrum feeding. Journal of Family Welfare. 37, 40-46.
Notes: Lack of clarity in data collection

Yoddumnern-Attig,B., Attig,G. and Kanungsukkasem,U. (1991) A people's perspective in nutrition education. World Health Forum 12, 406-412.
Notes: This is a useful general discussion of the process of nutrition education but does not present an evaluation with impact data of the programme that is described.

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6 Oral rehydration promotion and management of diarrhoea

Aguilar,A.M., Schaeffer,C. and Spain,P.L. (1988) Bolivian mothers clubs as media: building on community-based networks. Journal of Rural Health 4, 23-28.
Notes: This paper contains a very good description of the development of a communication interventions. However it is a descriptive account and, while briefly presenting findings from an evaluation, does not provide details of evaluation method, sampling, selection of controls, data collection methods and significance tests.

Alao,S.A. and Oladepo,O. (1991) Evaluation of factors affecting the adoption and use of sugar-salt-solution by mothers in Ibadan City, Oyo State, Nigeria. International Quarterly of Community Health Education 12, 119-128.
Notes: This is not an evaluation of an intervention. It is a cross-sectional survey which uses the data to make inferences about the adoption patterns of mothers.

Anonymous (1993) Diarrhoeal Diseases Control Programme. Evaluation of training and performance. Weekly Epidemiological Record 68, 239-241.
Notes: This is an evaluation of a diarrhoea training unit for training health workers in the management of diarrhoea. There is no impact data on the effect of the training on subsequent home management of diarrhoea by parents.

Bentley,M.E. (1988) The household management of childhood diarrhea in rural north India. Social Science and Medicine 27, 75-85.
Notes: Department of International Health, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD 21205. This is a study of management of diarrhoea in a community and does not relate the findings to an evaluation of existing health education/communication.

Bhattacharya,S., Biswas,R. and Saha,M.K. (1997) A study on impact of health education on rural mothers regarding oral rehydration therapy. Indian J. Public Health 42, 130-135.
Notes: The lack of specification of what specific knowledge, attitudes and practices were measured make it impossible to assess how meaningful this implementation is to control of diarrhoea. As a result the study can be cited in any discussion of interventions but its value is minimal.

Chowdhury,A.M.R., Vaughan,J.P. and Abed,F.H. (1988) Mothers learn how to save children. World Health Forum 9, 239-244.
Notes: Note the lack of detailed information on sampling, data collection, raw data, controls and significance tests limit the value of this study. Reference is made to a PhD thesis by one of the authors - A Mushtaque (1986) Evaluation of a community-based oral rehydration programme in rural Bangladesh PhD Thesis, University of London. There remains the possibility that a fuller account is present in this thesis.

Cliff,J., Cutts,F. and Waldman,R. (1990) Using surveys in Mozambique for evaluation of diarrhoeal disease control. Health Policy and Planning 5, 219-225.
Notes: This is a useful review of the value of surveys of home diarrhoea management knowledge and practice and their use in changing policy. However insufficient information is provided either from Mozambique or Philippines of existing diarrhoea communication activities for the report to provide an evaluation of existing diarrhoea communication activities.

Coreil,J. and Genece,E. (1988) Adoption of oral rehydration therapy among Haitian mothers. Social Science and Medicine 27, 87-96.
Notes: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa 33612
This is a survey of diarrhoea home management strategies in a community in which there has been some attempt to promote oral rehydration. Minimal information is provided of the promotional activities for oral rehydration. While the study does seek to correlate home management with knowledge of diarrhoea, there is no information provided on exposure to health communication on diarrhoea and ORT. The study does not provide an useful evaluation of the oral rehydration promotion activities in Haiti.

Cutting,W.A., Harpin,V.A., Lock,B.A. and Sedgwick,J.R. (1979) Can village mothers prepare oral rehydration solution? Trop. Doct. 9, 195-199.
Notes: This is really a feasibility study and not an evaluation of an intervention to promote ORS.

Eisemon,T.O., Patel,V.L. and Sena,S.O. (1987) Uses of formal and informal knowledge in the comprehension of instructions for oral rehydration therapy in Kenya. Social Science and Medicine 25, 1225-1234.
Notes: This is really an example (and a very good one) of the use of pretesting to improve the quality of printed materials. As such it is not an intervention, but part of the process of development of an intervention.

Eisemon,T.O. and Patel,V.L. (1990) Strengthening the effects of schooling on health practices in Kenya. Hygie 9, 21-29.
Notes: This paper provides a survey of the understanding of a group of women on diarrhoea, a pre-test of instructions on preparation of ORS and a review of the wording of school examination questions on diarrhoea. While providing a valuable discussion on the influence of schooling on diarrhoea it is not an evaluation of an intervention.

Elder,J., Touchette,P., SMith,W., Geller,S. and Foote,D. (1987) The healthcom project and the behavioral management of diarrhea. International Quarterly of Community Health Education 8, 201-211.
Notes: This paper provides a very good descriptive report of the use of a lottery as an incentive for promoting uptake of health care. No detailed data on impact is provided.

Elder,J.P., Pradesaba,M.E., Pineda,O.P., Enge,K.I., Graeff,J.A., Urban,D. and Romero,J. (1988) A behavior analysis of the promotion of oral rehydration therapy (ORT) in Guatemala. International Quarterly of Community Health Education 9, 139-150.
Notes: This report describes an observational study of the health education provided by health workers in clinics and also on actual preparation of ORS by mothers in the home. There is insufficient linkage of the clinic and home data for the study to be considered an evaluation of the impact of clinic-based health education on home practice of ORS.

Frankel,S.J. and Lehmann,D. (1984) Oral rehydration therapy: combining anthropological and epidemiological approaches in the evaluation of a Papua New Guinea programme. Journal of Tropical Medicine & Hygiene 87, 137-142.
Notes: The main data presented is that of a reduction of deaths from diarrhoea over the period of introduction of oral rehydration. There are no controls. The authors provide a detailed discussion of cultural issues that affect uptake of education about rehydration and ORT but the basis for the ethnographic discussion is not explained. . There is insufficient description of the health education/communication component of the programme for promotion of ORT and its impact.

Fryer,M.L. (1991) Health education through interactive radio: a child-to-child project in Bolivia. Health Education Quarterly 18, 65-77.
Notes: Education Development Center's Radio Education Project, La Paz, Bolivia. While percentage changes are given, no raw data on numbers including sample size are provided. The value of this evaluation is severely limited by the absence of controls and raw data. This is very disappointing because it is one of the few published evaluations of Child-to-Child activities.

Griffiths,M. (1990) Using anthropological techniques in program design: successful nutrition education in Indonesia. In: Coreil,J. and Mull,J.D., (Eds.) Anthropology and primary health care, Boulder S.F and Oxford: Westview Press]
Notes: No data is included in this paper to support the conclusions. It is mainly descriptive.

Hudelson,P.M. (1993) ORS and the treatment of childhood diarrhea in Managua, Nicaragua. Social Science and Medicine 37, 97-103.
Notes: Programme for the Control of Diarrhoeal Diseases, World Health Organization, Geneva, Switzerland
This is an ethnographic study of practices of mothers in Nicaragua. While it provides rich insights into the infuences on diarrhoea it does not provide an evaluation of the health education/communication activities on diarrhoea that took place.

Ippolito-Shepherd,J., Hollander,R.B. and Urrutia,J.J. (1991) Findings from formative evaluations. The health education components of the control of diarrhoeal disease programmes in five American countries. Hygie 10, 21-27.
Notes:This article does not provide any impact data on the interventions discussed.

Islam,M.A., Kofoed,P.E. and Begum,S. (1992) Can mothers safely prepare labon-gur salt-sugar solution after demonstration in a diarrhoeal hospital? Trop. Geog. Med. 44, 81-85.
Notes: The main aim of this programme seems to be to establish whether mothers can make up the ORS - i.e. the feasibility of making up and it is not an evaluation of a programme to promote ORS.

Islam,M.A., Biswas,E., Rahman,A.K. and Chakma,D.B. (1994) Factors associated with safe preparation and home use of sugar- salt solution. Public Health 108, 55-59.
Notes: A somewhat puzzling study. From the report it appears that mothers coming to group education were interviewed about their KAP with respect to diarrhoea, asked to measure ingredients for SSS, allowed to watch a demonstration and then asked to measure out ingredients again. There were no controls. The evaluation therefore measured enhancement in skill in preparation of SSS, not actual use. Little information is provided of the educational session.

Jacobs,M. (1988) Success for immunization project in Mozambique. Education for Health 2-4.
Notes: Raw data is not provided or details of evaluation methodology to support claims for success.

Kumar,V., Kumar,R. and Kurana,J.L. (1989) Assessment of the effect of training on management of acute diarrhoea in a primary health care setting. J. Diarrhoeal Dis. Res. 7, 70-76.
Notes: The main emphasis of this paper is on evaluation of training in terms of health worker performance and not on impact on community.

Mantra,I.B. and Davies,J. (1989) In rural Indonesia social marketing of oral rehydration salts the mothers' perspective. Hygie 8, 26-31.
Notes: Center for Community Health Education, Department of Health, Jakarta, Indonesia
This is a descriptive report and does not provide any data to support it.

Mawela,M.P. and de Villiers,F.P. (1999) The effect of admission on oral rehydration-related knowledge. Ann. Trop. Paediatr. 19, 75-81.
Notes: This is really an evaluation of the impact of existing procedures. No information is provided of the educational content within the ward and the data on impact is not supplemented with any observational analysis to document the actual educational activities.

Mtero,S.S., Dube,N. and Gwebu,E.T. (1988) Rural community management of diarrhoea in Zimbabwe: the impact of health education message on oral rehydration therapy. Central African Journal of Medicine 34, 240-243.
Notes: This is a general survey of a population and not an evaluation of a specified programme.

Mushtaque,A., Chowdhury,R. and Vaughan,J.P. (1988) Perception of diarrhoea and the use of a homemade oral rehydration solution in rural Bangladesh. Journal of Diarrhoeal Diseases Research 6, 6-14.
Notes: This is not an evaluation of an intervention but it does provide a valuable review of concepts that mothers hold about diarrhoea and their relevance for the promotion of ORT.

Oyoo,A.O., Burstrom,B., Forsberg,B. and Makhulo,J. (1991) Rapid feedback from household surveys in PHC planning: an example from Kenya. Health Policy and Planning 6, 380-383.
Notes: The main purpose of this paper is to demonstrate the value of rapid assessment methods and not to evaluate the educational component of CDD programme. The value of this paper is limited by the minimal description of educational methods and lack of baseline data.

Rahman,A.S., Bari,A., Molla,A.M. and Greenough,W.B. (1985) Mothers can prepare and use rice-salt oral rehydration solution in rural Bangladesh. Lancet 2, 539-540.
Notes: This is really a feasibility study of rice-salt solution for oral rehydration rather than an evaluation of its promotion in a community.

Riveron Corteguera,R.L. (1995) Strategies and causes of reduced infant and young child diarrheal disease mortality in Cuba, 1962-1993 [see comments]. Bull. Pan. Am. Health. Organ. 29, 70-80.
Notes: While valuable as a review of a large scale national programme, there is insufficient information presented to link declines in diarrhoea rates with programme inputs.

Sachar,R.K., Javal,G.S., Cowan,B. and Grewal,H.N. (1985) Home-based education of mothers in treatment of diarrhoea with oral rehydration solution. Journal of Diarrhoeal Diseases Research 3, 29-31.
Notes: No baseline and no controls.

Santoso,B. (1996) Small group intervention vs formal seminar for improving appropriate drug use. Social Science and Medicine 42, 1163-1168.
Notes: This study is an evaluation of impact of training on prescribing patterns and is not considered relevant for the Leeds Health Education Database because there is no impact data on the community

Schelp,F.P., Vivatanasept,P., Sitaputra,P., Sornmani,S., Pongpaew,P., Vudhivai,N. and Egormaiphol,S. (1990) Relationship of the morbidity of under-fives to anthropometric measurements and community health intervention. Tropical Medicine and Parasitology 41 , 120-126.
Notes: A rather confused study as it is not really written as an evaluation of an intervention. Comparisons of anthropometric data between control and intervention villages are not made. It is interesting as an example of the problems of 'contamination' of a control community through contact with the intervention villages.

Touchette,P., Douglass,E., Graeff,J., Monoang,I., Mathe,M. and Duke,L.W. (1994) An analysis of home-based oral rehydration therapy in the Kingdom of Lesotho. Social Science and Medicine 39, 425-432.
Notes: University of California, Irvine This is a basic field study of home practices and does not represent a formal attempt to evaluate education on oral rehydration provided by clinics.

Touchette,P.E., Elder,J. and Nagiel,M. (1990) How much oral rehydration solution is actually administered during home-based therapy? Journal of Tropical Medicine & Hygiene 93, 28-34.
Notes: An astonishing omission in this paper is the country/location where the study was done - a follow-up paper by the same author - does refer to the location as Mexico. The main focus of this paper is on analysis of home-prepared oral rehydration fluid and not to evaluate a promotional input.

Ueli,B. (1993) Oral rehydration therapy--qualitative studies of balance between pragmatism and scientific rigour in managing diarrhoea. Social Science and Medicine 36, 525-531.
Notes: An interesting review paper but most of the information presented is anecdotal and data on impact not provided. While it is removed from the Leeds Health Education Data-base it is worth considering the paper when reviewing interventions on ORT.

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7. Promotion of Immunization

Colle,R.D. (1979) The communication factor in health and nutrition programmes. A case study and guidelines for action, New York: Dept. Communication Arts, Cornell University.
Notes: This is a classic study of the use of audiocassettes and narrow casting. There is a very good account of the development of a nutrition education programme based on initial research. Unfortunately the evaluation was on a fairly limited scale with no significance testing of the changes achieved. The report has never been published and is an in-house report so there are problems of availability.

Couper,I.D. (1997) Health education: a baby show as an evaluation tool. Curationis 20, 41-42.
Notes: The thrust of this report is on the use of the baby show as an evaluation tool, not as an educational programme in its own right. As an evaluation tool it would seem flawed in that only a small proportion of the possible parents entered and, as shown by the high scores achieved these might be a self- selecting sample. Little information is provided of the nutrition education programme that was offered. Never-the-less this is an example of an interesting and creative approach to evaluation of health education from which lessons can be learned.

Cutts,F., Soares,A., Jecque,A.V., Cliff,J., Kortbeek,S. and Colombo,S. (1990) The use of evaluation to improve the Expanded Programme on Immunization in Mozambique. Bull. World Health Organ. 68, 199-208.
Notes: The evaluations are not related to health education/communication components of the immunization programmes.

de Fossard,E. (1993) Radio broadcasts on immunization to schools in Swaziland. In: Seidel,R.E., (Ed.) Notes from the field in communication for child survival, pp. 129-136. Washington,D.C.: HEALTHCOM, Academy for Educational Development]
Notes: Data to support conclusions not presented in this report (report may be available from Academy for Educational Development)

Ekunwe,E.O., Taylor,P., Macauley,R. and Ayodele,O. (2001) How disease prevention fails without good communication. World Health Forum 15, 340-344.
Notes: This is a report of an investigation on reasons for lack of uptake of immunization and is not an evaluation of an intervention.

el-Shazly,M.K., Farghaly,N.F., Abou-Khatwa,S.A. and Ibrahim,A.G. (1991) Comparative study of mothers' knowledge of children immunization before and after mass media. Journal of the Egyptian Public Health Association 66, 609-624.
Notes: This is not an evaluation of a specific mass media programme. Significance tests were not carried out. There were no baseline or controls. In effect it is a KAP study of mothers attending a clinic which seeks to ask why they attended.

Fauveau,V., Stewart,M.K., Chakraborty,J. and Khan,S.A. (1992) Impact on mortality of a community-based programme to control acute lower respiratory tract infections. Bull. World Health Organ. 70, 109-116.
Notes: No information is provided of the intervention apart from that of the training of the community health workers. It is not clear whether the CHWs were trained to carry out health communication activities among the mothers. It is difficult to ascribe programme impact to specific components of the intervention.

Gebreel,A.O. and Butt,J. (1997) Making health messages interesting. World Health Forum 18, 32-34.
Notes: Descriptive account with no impact data.

Jacobs,M. (1988) Success for immunization project in Mozambique. Education for Health 2-4.
Notes: Raw data is not provided or details of evaluation methodology to support claims for success.

Joseph,A., Abraham,S., Bhattachariji,S., Muliyil,J., John,K.R., Ethirajan,N., George,K. and Joseph,K.S. (1988) Improving immunization coverage. World Health Forum 9, 336-340.
Notes: Minimal description, lack of controls and supporting information to ascribe impact of specific programme inputs.

Kowli,S.S., Bhalerao,V.R., Jagtap,A.S. and Shrivastav,R. (1990) Community participation boosts immunization coverage. World Health Forum 11, 169-172.
Notes: This is an innovative programme which is often cited as an example of the successful use of the Child--to-Child approach. It is disappointing that the data presented in this report is not clearly defined, there are no controls, and the evidence for impact is poor.

Lee,T., Price,M. and Wynne,J. (1995) A comprehensive evaluation of a rural tuberculosis control programme in the south-eastern Transvaal: implications for health service planning. Southern African Journal of Epidemiology & Infection 10, 22-30.
Notes: This represents a good example of a health facility service evaluation but should not be considered an evaluation of an intervention.

Limtragool,P., Panichacheewakul,P., Stoekel,J. and Charoenchai,A. (1989) Health programme effects upon acceptance of immunisation in Northeast Thailand. Asia Pacific Journal of Public Health 3, 26-31.
Notes: This is a survey to determine reasons for acceptance or non-acceptance of immunization so does not represent an evaluation of a health communication intervention.

McBean,A.M., Foster,S.O., Herrmann,K.L. and Gateff,C. (1976) Evaluation of a mass measles immunization campaign in Yaounde, Cameroun. Trans. R. Soc. Trop. Med. Hyg. 70, 206-212.
Notes: No information is provided on health education/communication component of immunization programme

Ogundimu,F. (1994) Communicating knowledge of immunization for development: a case study from Nigeria. In: Moemeka,A.A., (Ed.) Communicating for Development - a new pan-disciplinary perspective, pp. 219-243. Albany: State University of New York]
Notes: This paper presents an interesting descriptive account of the use of mass media in immunization promotion in Nigeria. While it purports to be a content analysis, the analysis of content does not seem to have been carried out in a systematic way. Data is presented from a household survey but no information is provided of that survey. Furthermore the only evaluation data presented is a table suggesting that knowledge of whooping cough (not defined how measured) is not higher among those who report listening to radio more frequently. There are no controls.

Pandey,M.R., Sharma,P.R., Gubhaju,B.B., Shakya,G.M., Neupane,R.P., Gautam,A. and Shrestha,I.B. (1989) Impact of a pilot acute respiratory infection (ARI) control programme in a rural community of the hill region of Nepal. Annals of Tropical Paediatrics 9, 212-220.
Notes: Very little information is provided on the health education component of this programme

Pareja,R. (1993) Long distance health education for rural Ecuadoran mothers. In: Seidel,R.E., (Ed.) Communication for child survival - notes from the field, pp. 167-173. Washington,D.C.: Academy for Educational Development (AED), Communication and Marketing for Child Survival [HEALTHCOM]]
Notes: Raw data is not supplied in these reports although it might be useful to review this paper again at a later stage to assess its suitability.

Peeters,R.F., Alisjahbana,A. and Meheus,A.Z. (1986) Preventing neonatal tetanus: traditional birth attendants or immunization? Health Policy and Planning 1, 173-175.
Notes: This describes a research project currently underway at the time of publication. Unfortunately a search for a follow-up paper by the same authors describing the impact of the project described has not been successful.

Robinson,J.S., Burkhalter,B.R., Rasmussen,B. and Sugiono,R. (2001) Low-cost on-the-job peer training of nurses improved immunization coverage in Indonesia. Bull. World Health Organ. 79, 150-158.
Notes: The peer training included giving public presentations to inform and motivate mothers about immunizations, increasing attendances at educational sessions by better scheduling and using village volunteers more effectively and building closer ties with community leaders and sub-district officials. However no information is provided of the performance of these activities and the extent to which they may have influenced subsequent immunization coverage.

Ross,D.A. (1986) Does training TBAS prevent neonatal tetanus? Health Policy and Planning 1, 89-98.
Notes: This is a review of the impact of training TBAs on neo-natal tetanus and as such the outcome measure is health worker performance and not impact on community practices.

Shanks,G.D. (1985) DPT immunisation following radio announcement of a diphtheria in Belize. Bull. Pan. Am. Health. Organ. 19, 384-387.
Notes: Whilst providing striking evidence of the power of news reports to influence action, this paper does not provide an evaluation of a planned and deliberate health education activity.

Smith,W.A., Pareja,R., Booth,E. and Rasmuson,M. (1984) Health communication for ORT in Honduras. Assignment Children 57-93.
Notes: The educational methods for this programme are particularly well described and it is unfortunate that this report contains no raw data. Given the well established nature of the implementing agency (Academy of Educational Development) it is hoped that it may be possible to obtain a full report with details of research methodology and impact data and thus reinstate this intervention in the Leeds Health Education Database.

Sundari,T.K. (1993) Can health education improve pregnancy outcome? Report of a grassroots action-education campaign. Journal of Family Welfare 39, 1-12.
Notes: The study does show higher % of delivery of mothers with complications in hospital facilities but there is no significance testing, controls or baselines. Pregnancy outcomes are compared with studies elsewhere in country but these are not an adequate replacement for properly assigned controls. There is a wider problem in that a switch from home to hospital delivery should not be considered on its own as an indicator of success - it is necessary to demonstrate that mothers have used the health education to make a conscious decision whether their pregnancy outcome is one of likely high risk and have acted on this decision to stay at home or go for delivery at hospital.

Unger,J.P. (1991) Can intensive campaigns dynamize front line health services? The evaluation of an immunization campaign in Thies health district, Senegal. Social Science and Medicine 32, 249-259.
Notes: The absence of any consideration of the communication component of the activity makes this report not very useful for assessing the impact of health education immunization coverage.

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8. Acute Respiratory Infections

Akin,L. (1992) Turkey: Mothers education. ARI News 7-7.
Notes: This is a short piece in a newsletter with no data or research methodology/analysis presented

Mehnaz,A., Billoo,A.G., Yasmeen,T. and Nankani,K. (1997) Detection and management of pneumonia by community health workers--a community intervention study in Rehri village, Pakistan. J. Pak. Med. Assoc. 47, 42-45.
Notes: Note- this study does not measure impact on the behaviour of mothers - only improved performance so it is not in the intervention data-base

Mtango,F.D. and Neuvians,D. (1986) Acute respiratory infections in children under five years. Control project in Bagamoyo District, Tanzania. Trans. R. Soc. Trop. Med. Hyg. 80, 851-858.
Notes: No information on health education contact and no impact data of health education component of ARI

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9. Growth Monitoring

Gerein,N.M. and Ross,D.A. (1991) Is growth monitoring worthwhile? An evaluation in its use in three child health programmes in Zaire. Social Science and Medicine 32, 667-675.
Notes: This is an evaluation of the quality of health education given during growth monitoring. It is a very good study of the performance of health workers but contains no information on the impact of the growth monitoring advice on the feeding/child care behaviour of the mothers. For this reason it has been excluded from the Leeds Education Database. However, most of the studies of growth monitoring that have been retained in the database would have benefited considerably if they had included an observational study of this kind.

Ghosh,S. and et al (1977) Domestic visualisation: an innovative approach to health education. J. Trop. Pediatr. December, 282-285.
Notes: Lack of controls and follow-up of drop-outs seriously limits the value of this study.

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10. Nutrition Education

Aubel,J. and Samba-Ndure,K. (1996) Lessons on sustainability for community health projects. World Health Forum 17, 52-57.
Notes: The main thrust of this evaluation is on the acceptability of the weaning food. There is a useful discussion on the process of nutrition education and obstacles encountered but no impact data data is presented on effect of the educational programme

Brown,L.V., Rogers,B.L., Zeitlin,M.F., Gershoff,S.N., Huq,N. and Peterson,K.E. (1993) Comparison of the costs of compliance with nutrition education messages to improve the diets of Bangladeshi breastfeeding mothers and weaning-age children. Ecology of Food and Nutrition 30, 99-126.
Notes: This is a further discussion of the results of two interventions that are in the Leeds Database by the same authors. Whilst comparing costs to mothers of adopting interventions, it does not provide evidence of impact.

Carr,D. (1988) Village mothers on the West Bank learn about health. World Health Forum 9, 245-249.
Notes: This is a descriptive report and no data is presented on impact of the programme.

Chaurasia,A. (1995) Informing, educating and communicating with people iodine deficiency disorders elimination drive in Madhya Pradesh. Indian J. Public Health 39, 160-163.
Notes: This report is mainly descriptive with no impact data.

Curtale,F., Siwakoti,B., Lagrosa,C., LaRaja,M. and Guerra,R. (1995) Improving skills and utilization of community health volunteers in Nepal. Social Science and Medicine 40, 1117-1125.
Notes: While showing differences between control and intervention groups, lack of a baseline or supporting data showing an increase had taken place limits the value of this as an evaluation of the project.

Devadas,R.P. (1978) Integrating nutrition education into primary school curriculum in India. Journal of Nutrition Education 10, 113-115.
Notes: No description of data collection instruments, no controls and no significance tests.

Devadas,R.P., Chandrasekhar,U. and Anandi,G. (1979) Dissemination of nutrition information through parent teacher associations in two different primary schools. Indian Journal of Nutrition and Dietetics 16, 43-48.
Notes: No controls and no significance tests.

Doyle,E.I. and Feldman,R.H. (1994) Are local teachers or nutrition experts perceived as more effective among Brazilian high school students? Journal of School Health 64, 115-118.
Notes: This is a variant on the classic Harvard studies of source credibility. The three intervention groups received a written nutrition message with different sources ascribed to them and their impact compared with each other and a control. This could be seen as an evaluation of the impact of written material and therefore appropriate for the Leeds Database. However the whole thrust of the discussion is on comparison of the different sources, the description of the intervention is minimal and little information is provided of the measuring instruments for changes in nutrition attitude.

Doyle,E.I., Feldman,R.H.L. and Keller,J. (1995) Nutrition Education and Gender Differences: Working with Brazilian Adolescents. Health Values - The Journal of Health Behaviour, Education and Promotion 19, 10-17.
Notes: This is a cross sectional study to determine association of food choice with subjective norms and is not an evaluation of an intervention.

Drummond,T. (1975) Using the method of Paulo Freire in nutrition education. an experimental plan for community action in North-east Brazil. Cornell University International Nutrition Monograph 3,
Notes: This is an old publication which falls out of the period of coverage of the database. there is a good description of their operationalisation of Paulo Freire's method to nutrition. However the project was a student project and only implemented for 3 months with limited outcome measures. It is also firmly rooted in the outdated 'protein era' of nutrition.

Ekeh,H.E. (1985) The impact of health education on the nutritional status of low- income group children in Ibadan. Hygie 4, 15-18.
Notes: There were no controls of baseline. The educational programme is not described and the only outcome measure is weight gain as recorded in a child clinic. It is not possible to ascribe any weight gain to specific health education inputs.

Feldman,R.H.L. (1988) Nutrition education in Kenya: the development of a communication. In: Carlaw,R.W. and Ward,W.B., (Eds.) Primary health care: the African experience. Volume two in a series of case studies in community health education, pp. 199-219. Oakland, California: Third Party Publishing Company]
Notes: This study sets out to do in Kenya the same kind of study as the author has published in Brazil (ref ID 5536) - an exploration of the impact of different sources on attitude change of the adolescent. This involved showing pupils a printed nutrition message with an accompanying description of the source with a control group receiving no source. Raw data is not presented in this report.

Hoorweg,J. and McDowell,I. (1979) Evaluation of nutrition education in Africa. Community research in Uganda 1971-72, The Hague: Mouton Publishers.
Notes: This monograph has quite a good discussion on evaluation methodology. It presents data from a post-test only study comparing the effect of nutrition education on an intervention group and a control group that have only attended the clinic for the first time. There is no baseline (although the reasons for this are explained). However a limitation of this study is that the changes that it seeks are rooted within the concept of protein deficiency which is no longer considered an appropriate objective for nutrition education.

Kotchabhakdi,N.J., Winichagoon,P., Smitasiri,S., Dhanamitta,S. and Valyasevi,A. (1987) The integration of psychosocial components in nutrition education in northeastern Thai villages. Asia Pacific Journal of Public Health 1, 16-25.
Notes: This publication is not clearly written and it is difficult to determine the results of the intervention from the data presented. Significance tests are presented for only one of the changes determined.

Madeley,J. (1992) Preventing blindness in Zambia. WORLD HEALTH 20-21.
Notes: This is a descriptive study by a journalist and contains no data on impact of the programme.

Matthews,C.M., Benjamin,V., Samikkannu,K.C., Punithavithy,C. and Palocaren,A. (1977) Education to overcome malnutrition in rural preschool children. International Journal of Health Education 20, 1-19.
Notes: The evaluation procedure in this paper is not clearly explained, it is not clear how many are in controls or intervention groups and the data collection methods are not described, raw data not provided, just charts for much of the information.

Melville,B., Rainford,K., Collins,L. and Wilkins,D. (1992) An assessment of the impact of two communication channels on knowledge, attitude and practices of mothers regarding food and nutrition in Jamaica. International Quarterly of Community Health Education 13, 63-75.
Notes: The intervention is an interesting one. The sample size of 15 in each of the three intervention groups is quite small. Although there is some statistical treatment of the data, there appear to be no significance tests carried out to support apparent differences in changes in nutrition knowledge with the different intervention methods.

Muroki,N.M., Maritim,G.K., Karuri,E.G., Tolong,H.K., Imungi,J.K., Kogi-Makau,W., Maman,S., Carter,E. and Maretzka,A.N. (1997) Involving rural Kenyan women in the development of nutritionally improved weaning foods: nutribusness strategy. Journal of Nutrition Education 29, 335-342.
Notes: This provides a good discussion of ways of working with women but does not represent an evaluation of an intervention.

Parvanta,C.F., Gottert,P., Anthony,R. and Parlato,M. (1997) Nutrition promotion in Mali: highlights of a rural integrated nutrition communication program (1989-1995). Journal of Nutrition Education 29, 274-280.
Notes: Hopefully it will be possible to get a copy of the full report which provides the data upon which the conclusions in this paper are based. This report in its present form is not adequate as the description of the evaluation method is very limited and data are not provided.

Puri,R. and Mehta,S. (1994) Impact of nutrition and health education on rural pre-school children. Indian Pediatr. 31, 9-14.
Notes: No information is presented on the educational content and methods of the nutrition education. Although the intervention was tested out with different income groups there were no controls who did not receive the intervention. Impact data is presented on hygiene behaviour including hand washing and food hygiene practices but no information is provided on the methodology that is needed to evaluate these in an objective way.

Ramadasmurthy,V., Rao,V.R., Naidu,A.N. and Mohanram,M. (1984) Nutrition education among industrial workers in India. Hygie 3, 6-10.
Notes: There were no controls. This is a serious limitation in evaluations based only on demonstration of dietary change because of the confounding effect of seasonal variations (which are not discussed by the authors).

Shingwekar,A.G., Gopaldas,T., Srinivasan,N., Bhargava,V. and Seth,R. (1977) Nutritional rehabilitation at the hut level: educational impact. Journal of Tropical Pediatrics & Environmental Child Health 23, 97-102.
Notes: This mainly deals with nutrition rehabilitation and not the nutrition component, There were no controls. There are some interesting insights into the impact of a nutrition rehabilitation programme on the community but the measurement of this impact is not carried out with any great precision.

Smitasiri,S., Attig,G.A. and Dhanamitta,S. (1992) Participatory action for nutrition education: social marketing vitamin A-rich foods in Thailand. Ecology of Food and Nutrition 28, 199-210.
Notes: This paper contains a very good discussion of issues involved with nutrition education and Vitamin A. It describes an ongoing research programme but does not present any impact data.

Stanton,B.F., Phillips,N., Clemens,J.D., Wroot,B., Gafur,Z., Fleischman,J. and Khair,T. (1987) An urban nutrition education and rehabilitation centre: a description of the programme and change in nutritional status of children who were enrolled. Trop. Geog. Med. 39, 287-295.
Notes: There were no controls. However, a bigger problem with interpreting this study is that the evaluation only measured weight gain and health status of the children. During their stay at the nutrition rehabilitation center (which was during the daytime only) children received food supplements and it is not possible to determine whether the impact on nutrition was due to the education or the food supplements. A more useful evaluation would have explored the impact of the stay in the nutritional rehabilitation centre on the mothers feeding and child care practices at home both during the period of stay and afterwards.

Suttapreyasri,D., Simasing,Y., Tanthanantana,M., Thunpithayakyl,P., Prasertsreuy,S., Srijuntr,N. and Leenasen,C. (1983) Changes of nutritional behavior of level - 6 pupils in three different schools in Bangkok. Journal of the Medical Association of Thailand 66 Suppl 1, 41-48.
Notes: The description of the methodology in this report is not clear. The intervention takes place in three different kinds of schools and results are compared across. However it is also suggested from a diagram that controls were established within these schools but details are not provided of this and there is no comparison of impact between controls and intervention classes. Information is not provided of the data-collection instruments.

Swarnalatha,A.M. (1992) Assessing the effectiveness of four teaching approaches in increasing the knowledge of rural mothers in nutrition. Indian Journal of Adult Education 53, 73-80.
Notes: The small sample size (n=36), lack of controls and restriction of outcome measures to knowledge (the nature of which is not described) seriously limit the value of this study

Ticao,C.J. and Aboud,F.E. (1998) A problem-solving approach to nutrition education with Filipino mothers. Social Science and Medicine 46, 1531-1541.
Notes: Note: The intervention consists of putting pairs of women together without any educational input - the study explores pairs of women's capacity to solve nutritional problems presented to them and not an educational intervention is provided to enhance the capacity for solving problems. Note that the problems that mothers were given to solve were one's that might reasonably be expected to deal with without additional information of a specialist nature. While of considerable interest, this intervention is considered to fall outside the terms of reference of the Leeds Health Education Database.

Tragler,A.T., Bhatt,S.S. and Fernandez,A. (1981) Assessment of health education in nutrition. J. Trop. Pediatr. 27, 221-223.
Notes: There are no controls and no baseline.

Visitsunthorn,N. and Wongarn,R. (1995) Childhood malnutrition: an analysis of the effects of nutritional advice. Southeast Asian J. Trop. Med. Public Health 26, 286-290.
Notes: There are no controls. Just by following a cohort of children and demonstrating improvement is not sufficient. In the absence of controls there should be some accompanying information to explain why improvement in nutritional status took place and associate it with the intervention.

Walia,B.N.S., Gambhir,S.K., Kumar,D. and Bhatia,S.P.S. (1985) Feeding from the family pot for prevention of malnutrition. Food and Nutrition Bulletin 7, 43-46.
Notes: It is not clear from the data whether the impact achieved was due to the food supplementation programme or nutrition education.

Yankauer,A. (1975) An evaluation of nutrition classes for mothers in a pediatric clinic setting. J. Trop. Pediatr. 21, 90-92.
Notes: This is excluded from the database both because of the data criterion and also because of the small sample size (intervention n=51, control n=53) and there are no significance tests.

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11. Control of infections diseases including tropical and parasitic diseases - malaria, TB, Schistosomiasis, worms, Chagas, Dengue, Leprosy

A/Rahman,S.H., Mohamedani,A.A., Mirgani,E.M. and Ibrahim,A.M. (1996) Gender Aspects and Women's Participation in the Control and Management of Malaria in Central Sudan. Social Science and Medicine 42, 1433-1446.
Notes: There is no impact data and is a study of the performance of women volunteers and does not go on to measure the impact of their work on community

Adeyanju,O.M. (1987) A community-based health education analysis of an infectious disease control programme in Nigeria. International Quarterly of Community Health Education 8, 263-279.
Notes: This study seems to draw upon the same data as: Akpovi,S.U., Johnson,D.C. and Brieger,W.R. (1981) Guinea worm control: testing the efficacy of health education in primary care. International Journal of Health Education 24, 229-237. While containing an interesting descriptive account of Guinea worm prevention activities no raw data or statistical analysis is prevented to support % figures given for changes in knowledge of preventive measures. Other data is not provided to support claims for impact of programme.

Akpovi,S.U., Johnson,D.C. and Brieger,W.R. (1981) Guinea worm control: testing the efficacy of health education in primary care. International Journal of Health Education 24, 229-237.
Notes: While providing an interesting narrative account, the educational inputs especially the content of training of local community members is not provided, raw data on impact is not described, details of measuring instruments used in the survey after the first year are not provided and subsequent information on impact is mainly anecdotal.

Aryeetey,M.E., Aholu,C., Wagatsuma,Y., Bentil,G., Nkrumah,F.K. and Kojima,S. (1999) Health education and community participation in the control of urinary schistosomiasis in Ghana. East African Medical Journal 76, 324-329.
Notes: This paper contains quite an interesting discussion on concepts about schistosomiasis but is seriously flawed by the lack of any analysis of focus group discussions to support the author's conclusions.

Barnhoorn,F. and Adriaanse,H. (1992) In Search of Factors Responsible for Noncompliance among Tuberculosis Patients in Wardha District, India. Social Science and Medicine 34, 291-306.
Notes: This study was carried out to find out differences between compliant and non-compliant patients. No information is provided of the health education provided to the patient and the patient's perception of this information . While pointing to the need for heath education, the study does not represent an evaluation of the existing health education

Berreman,J.M. (1984) Childhood leprosy and social response in south India. Social Science and Medicine 19, 853-865.
Notes: This is not so much an evaluation of an educational programme, more a discussion of the social issues arising from an educational programme. It provides very interesting discuss but presents no data on impact.

Brieger,W.R. (1996) Health education to promote community involvement in the control of tropical diseases. Acta Tropica 61, 93-106.
Notes: This is a general review and does not present any specific information on an intervention.

Chen,P.C. and Sim,H.C. (1986) The development of culture-specific health education packages to increase case-finding of leprosy in Sarawak. Southeast Asian J. Trop. Med. Public Health 17, 427-432.
Notes: This describes work in progress for the development of health education materials on leprosy. There is not evaluation of the materials presented in this report.

Chongsuvivatwong,V., Pas-Ong,S., Ngoathammatasna,W., McNeil,D., Vithsupakorn,K., Bridhikitti,V., Jongsuksuntigul,P. and Jeradit,C. (1994) Evaluation of hookworm control program in southern Thailand. Southeast Asian J. Trop. Med. Public Health 25, 745-751.
Notes: No information is provided of the health education component of the programme. While claims are made about coverage, no information is provided of how coverage of the population was measured. In effect, this study is mainly concerned with a programme of treatment with anti-helminthics.

Dharmalingam,T. and Shanmugan,P. (1982) The complexities of health education in leprosy. International Journal of Health Education 24, 176-182.
Notes: This is really a description of a four week student project involving a KAP study and health education activities. The only outcome measures is a small increase in case detection but it is not obvious whether that is due to increased case finding by the project or a result of the health education. There is a good discussion of the implications of the KAP study but it does not represent an evaluation of an educational intervention.

Engels,D., Ndoricimpa,J., Nahimana,S. and Gryseels,B. (1994) Control of Schistosoma mansoni and intestinal helminths: 8-year follow-up of an urban school programme in Bujumbura, Burundi. Acta Tropica 58, 127-140.
Notes: Although the report contains a brief description of the local production of a video supported by drama and drawing contests, the main thrust of the paper is on the impact of selective chemotherapy and there is no discussion of the contribution of the educational programme to the impact achived.

Gad,A., Mandil,A.M.A., Sherif,A.A.R., Gad,Z.M. and Sallam,S. (1997) Compliance with antituberculosis drugs among tuberculosis patients in Alexandria, Egypt. Eastern Mediterranean Health Journal 3, 244-250.
Notes: This reference has not been included in the intervention database because there was no information provided of the patient education given to patients during their consultation.

Ghebreyesus,T.A., Alemayehu,T., Bosman,A., Witten,K.H. and Teklehaimanot,A. (1996) Community participation in malaria control in Tigray region Ethiopia. Acta Tropica 61, 145-156.
Notes: This was removed from the intervention database because health education is only one component of the programme and it is impossible to tell from the data what the contribution of health education was. There is no discussion of the health education role of village health workers.

Gubler,D.J. and Clark,G.G. (1996) Community involvement in the control of Aedes aegypti. [Review] [21 refs]. Acta Tropica 61, 169-179.
Notes: This is a review paper and does not present primary data on the case studies described.

Kartikeyan,S. and Bhalerao,V.R. (1986) Study of compliance of the patients in leprosy control programme in an urban slum. Journal of Postgraduate Medicine 32, 127-130.
Notes: This is a study of defaulters on an ongoing programme to provide data for planning a health education intervention and is not an evaluation of an ongoing intervention.

Katsivo,M.N., Muthami,L.N., Kimani,S., Karama,M. and Kingori,F. (1993) Involvement of a community in schistosomiasis control: a Kenyan experience. East African Medical Journal 70, 478-481.
Notes: The discussion of the impact of the project is mainly descriptive with minimal descriptions of data collection methods and presentation of data on impact. There were no controls.

Katsivo,M.N., Muthami,L.N., Karama,M. and Kingori,F. (1993) Perception of a schistosomiasis control project in rural Kenya by the beneficiaries. East African Medical Journal 70, 613-616.
Notes: The survey measured perceptions of the project by beneficiaries. The only impact data provided are those of egg-counts of urine before and after the intervention. However details of the parasitological studies and only percentages and not the raw data are presented with no statistical analysis.

Kumar,A., Biswas,G. and Joshi,G.C. (1993) Guinea worm disease surveillance and community education through weekly village markets. J. Commun. Dis. 25, 140-144.
Notes: not considered for intervention data-base because the emphasis was on case-finding and did not seek to influence community behaviour

Locketz,L. (1976) Health education in rural Surinam; use of videotape in a national campaign against schistosomiasis. Bull. Pan. Am. Health. Organ. 10, 219-226.
Notes: While containing a useful description, lack of impact data limits the value of this study.

Mfaume,M.S., Winch,P.J., Makemba,A.M. and Premji,Z. (1997) Mosques against malaria. World Health Forum 18, 35-38.
Notes: The main achievement of this study is to show acceptability to preachers and audience in four mosques of inclusion of malaria in sermons. 39 members of audience and five non-attenders were interviewed. While some general data on impregnation of bed nets is included in study it is impossible to determine contribution of mosque intervention

Mutatkar,R.K. (1977) Health education in leprosy: an evaluation. Lepr India 49, 234-239.
Notes: Minimal description is provided of the health education intervention and impact achieved.

Mutatkar,R.K. and Ranade,M.G. (1986) Evaluation of health education in leprosy control programme: methodological considerations. Southeast Asian J. Trop. Med. Public Health 17, 437-441.
Notes: While discussing methodological issues, no data on impact is presented in this paper.

Naik,S., Samant,S.G. and Godbole,P.M. (1988) Involvement of students in a leprosy health education programme - an experiment. Lepr. Rev. 59, 255-258.
Notes: This report contains no impact data

Narasimham,M.V.V.L. and et al (1983) Voluntary community participation in the control of vector borne diseases - filariasis. J. Commun. Dis. 15, 106-110.
Notes: Door to door health education was provided but insufficient description of the health education. Impact on filariasis shown.

Okanurak,K., Sornmani,S. and Chitprarop,U. (1991) The role of folk healers in the malaria volunteer program in Thailand. Southeast Asian J. Trop. Med. Public Health 22, 57-64.
Notes: This was removed from intervention data-base because it is only a measure of performance of volunteers and not on impact on community

Okanurak,K. and Sornmani,S. (1992) Community participation in the malaria control program in Thailand: a review. Southeast Asian J. Trop. Med. Public Health 23 Suppl 1, 36-43.
Notes: This is a general review of two programmes and does not contain much specific information on outcomes . The discussion tends to equate community participation just with use of volunteers.

Okanurak,K. and Ruebush,T.K.2. (1996) Village-based diagnosis and treatment of malaria. Acta Tropica 61, 157-167.
Notes: Note - rejected from Leeds Health Education Database because it is essentially a review of performance of volunteers rather than impact on community -

Okanurak,K., Sornmani,S. and Chitprarop,U. (1996) The impact of folk healers on the performance of malaria volunteers in Thailand. Final report of a project supported by the TDR Social and Economic Research Component, Geneva: UNDP/World Bank/WHO Special Programme for Research ant Training in Tropical Diseases (TDR).
Notes: see published study ref 1390. This is a study of the performance of volunteers after training and does not contain data on the impact of the trained volunteers on the community

Okoth,J.O., Omare-Okurut,A. and Eboyu,F. (1998) The use of theatre to mobilize and sensitize rural communities to participate in tsetse control in Bugiri district, Busoga, Uganda: a case study. Ann. Trop. Med. Parasitol. 92, 127-128.
Notes: This is a descriptive account with no data presented on impact

Ramakrishna,J. and Brieger,W.R. (1987) The value of qualitative research: health education in Nigeria. Health Policy and Planning 2, 171-175.
Notes: The level of detail on the case studies presented on malaria is very limited so this paper has not been considered for inclusion in the Leeds HE Data-base

Renshaw,J. and Rivas,D. (1991) A community development approach to Chagas' disease: the Sucre health project, Bolivia. Health Policy and Planning 6, 244-253.
Notes: This paper provides a very good description of the process of the development of a community-based health education programme for control of Chagas disease. Unfortunately no data is provided on coverage or impact. While it states that the insect vector has been eradicated in the intervention villages no data are provided to justify that remark. The report does not provide the necessary detail to sever as an example of process evaluation.

Scorzelli,J.F. (1988) Assessing the effectiveness of Malaysia's drug prevention education and rehabilitation programs. Journal of Substance Abuse Treatment 5, 253-262.
Notes: While this paper provides a good description of national drug education programmes the main data cited to evaluate the drug education programme are reported figures for drug abuse in schools and general population which might be caused by many factors including law enforcement. There is no information presented that specifically examines the impact of the educational programme or which attributes the data on dug abusers to the educational programme.

Sharma,V.P. and Sharma,R.C. (1989) Community based bioenvironmental control of malaria in Kheda District, Gujurat, India. Journal of the American Mosquito Control Association 5, 514-521.
Notes: It is very difficult to tell from the paper what exactly took place and the basis for the evidence for the claims made and the paper has been withdrawn from the Leeds Health Education database -

Stallworthy,G. (1977) Social marketing of impregnated bed nets in Mashonaland Central, Zimbabwe, Washington: Population Services International.
Notes: A very interesting study with many insights into issues of carrying out social marketing of ITBNs. The report is limited by lack of baseline, controls and that survey data is presented as % only and no raw data given or statistical treatment. It is a pity that it has not been published.

van Gorkom,J. and Kibuga,D.K. (1996) Cost-effectiveness and total costs of three alternative strategies for the prevention and management of severe skin reactions attributable to thiacetazone in the treatment of human immunodeficiency virus positive patients with tuberculosis in Kenya. Tubercule and Lung Disease 77, 30-36.
Notes: This paper has been rejected from the Leeds Database because it is not an evaluation of an intervention but represents a cost-effectiveness analysis from existing published studies of alternative approaches to management TB patients - one approach being to educate about side effects.

Yasumaro,S., Silva,M.E., Andrighetti,M.T.M., Macoris,M.d.G., Mazine,C.A.B. and Winch,P.J. (1998) Community involvement in a Dengue prevention project in Maríia, Sao Paulo State Brazil. Human Organisation 57, 209-214.
Notes: This is a fascinating account of how the community's perceptions of solid waste can be different from the authorities. It is not included in the database because, while it describes observations from an intervention it does not present any evaluation of impact either qualitative or quantitative. It does provide an interesting commentary on the process.

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12 Oral/dental health promotion

Esheng,Z., Jixiong,W. and Huali,L. (1992) National Look After Your Teeth Day. An analysis of effects of a contest in Wuhan City. Hygie 11, 34-34.
Notes: 93106625 Dept. of Sch. Health, Wuhan Public Health and Anti- epidemic Station
No baseline data - just reports level of knowledge after mass media oral health campaign.

Robison,V.A., Mosha,H.J. and Masalu,J.R.P. (1999) An evaluation of oral health flip charts in maternal child health clinics
in Tanzania. International Journal of Health Promotion and Education 47-51.
Notes: Evaluation was through observation of their use and not through data on impact on the audiences.

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13 Eye Health

Madeley,J. (1992) Preventing blindness in Zambia. WORLD HEALTH 20-21.
Notes: This is a descriptive study by a journalist and contains no data on impact of the programme.

Richards,F., Jr., Gonzales-Peralta,C., Jallah,E. and Miri,E. (1996) Community-based ivermectin distributors: onchocerciasis control at the village level in Plateau State, Nigeria. Acta Tropica 61, 137-144.
Notes: While providing a very good discussion of the issues involved in moving from a mass distribution to a community-based distribution - this is not an evaluation of an intervention.

Seidel,R.E.ed. (1996) Strategies for promoting Vitamin A production, consumption and supplementation - four case studies, Washington: Academy for Educational Development.
Notes: The interventions are very well described - unfortunately this publication is mainly directed at advocacy and provides no raw data or details of data collection that is needed to assess the validity of the findings.

Shu,E.N., Nwadike,K.I., Onwujekwe,E.O., Ugwu,O.C. and Okonkwo,P.O. (1999) Influence of health education on community participation in rapid assessment of onchocerciasis prior to distribution of ivermectin. East African Medical Journal 76, 320-323.
Notes: This has been rejected from the Leeds HE data-base because there is no baseline, there is no information on sampling the men and there are no significance tests to support the alleged findings of superior ability to recognize symptoms of onchocerciasis.

Shu,E.N., Onwujekwe,E.O., Lokili,P. and Okonkwo,P.O. (2000) A health club for a community school in south-eastern Nigeria: influence on adult perception of onchocerciasis and compliance with community-based ivermectin therapy. Trop. Med. Int. Health 5, 222-226.
Notes: This is a somewhat confused and disappointing paper in that it seems to measure the impact of a school health club without providing any information on the operation of the club. A pre-and post-test survey of adults shows an increase in Ivermectin compliance but there is no information on their participation in the health clubs or controls. Thus it is not clear why the change took place and if the health club played a role.

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14 Environmental health including water, sanitation and hygiene education

A/Rahman,S.H., Mohamedani,A.A., Mirgani,E.M. and Ibrahim,A.M. (1996) Gender Aspects and Women's Participation in the Control and Management of Malaria in Central Sudan. Social Science and Medicine 42, 1433-1446.
Notes: There is no impact data. This is a study of the performance of women volunteers and does not go on to measure the impact of their work on community

Akpovi,S.U., Johnson,D.C. and Brieger,W.R. (1981) Guinea worm control: testing the efficacy of health education in primary care. International Journal of Health Education 24, 229-237.
Notes: While providing an interesting narrative account, details of the educational inputs especially the content of training of local community members are not provided, raw data on impact are not described, details of measuring instruments used in the survey after the first year are not provided and subsequent information on impact is mainly anecdotal.

Andriessen,P.P., van-der-Endt,R.P. and Gotink,M.H. (1990) The village worker project in Lesotho: an evaluation. Trop. Doct. 20, 111-113.
Notes: This is a descriptive report of the performance of village health workers with no impact data on the effect of the programme on the community.

Biswas,A.B., Roy,A.K., Das,K.K., Sen,A.K. and Biswas,R. (1990) A study of the impact of health education imparted to school children on their knowledge, attitude and practice in regard to personal hygiene. Indian J. Public Health 34, 87-92.
Notes: The value of this study is seriously limited by the lack of controls and any information on the content of the health education or the specific nature of the knowledge and behaviour changes targeted and the nature of the scores.

Bohari,H., Nor,I.M. and Hashim,M.N. (1989) A Pour-Flush Latrine Programme in a rural community in Malaysia: an early evaluation. Hygie 8, 15-19.
Notes: There were no controls and any other forms of data collection to infer causality. Details of the measuring instruments are not given and raw data is not provided - only %.

Chandiwana,S.K., Taylor,P. and Matanhire,D. (1991) Community control of schistosomiasis in Zimbabwe. Cent. Afr. J. Med. 37, 69-77.
Notes: Blair Research Laboratory, Causeway, Harare, Zimbabwe. The value of this paper is severely limited by the lack of explanation or data from the pre-and post-inervention KAP studies that were claimed to have taken place, lack of controls and difficulty in ascribing outputs of reduced snail infestation (minimal data supplied) or of prevalence of schistosomiasis.

Demehin,P.A.O. (1988) Developing a programme to eradicate a cholera outbreak in Ijare, Ondo State, Nigeria. In: Carlaw,R.W. and Ward,W.B., (Eds.) Primary health care: the African Experience. Volume two in a series of case studies in community health education, pp. 387-399. Oakland,Ca.: Third Party Publishing Company]
Notes: An interesting account of a programme but lack of any data on impact limits its usefulness

Dieleman,M. (1998) Measuring change in behavior: Burkina Faso - an analysis of a participatory evaluation method of hygiene eudcation for water and sanitation. International Quarterly of Community Health Education 18 (4):435-448.
Notes: The title is misleading as it is a discussion on evaluation methodology for hygiene education which takes as a starting point the evaluation of a particular intervention. However, no actual data is presented for that intervention. Nevertheless there are some interesting comments about evaluation so it is a useful paper on methodology but does not represent an evaluation of an intervention. There are no controls.

El-Katsha,S. and Watts,S. (1994) A model for health education. World Health Forum 15, 29-33.
Notes: lack of data on impact limits the value of this report which has been rejected from the Leeds HE database

Han,A.M., Hlaing,T., Kyin,M.L. and Saw,T. (1988) Hand washing intervention to reduce ascariasis in children. Trans. R. Soc. Trop. Med. Hyg. 82, 153-153.
Notes: This primarily an epidemiological intervention and so is not considered part of the Leeds Health Education Database.

Han,A.M. and Hlaing,T. (1989) Prevention of diarrhoea and dysentery by hand washing. Trans. R. Soc. Trop. Med. Hyg. 83, 128-131.
Notes: This is an intervention study to determine the impact of handwashing on health and not a study to promote handwashing.

Hospedales,J., Holder,Y., Deyalsingh,I., Paul,R. and Rosenbaum,J. (1993) Private sector response against the cholera threat in Trinidad and Tobago. Bull. Pan. Am. Health. Organ. 27 , 331-336.
Notes: An interesting descriptive account of the involvement of the press in cholera prevention but ther is no data presented to evaluate the programme.

Hurtado,E. and Mills-Booth,E. (1995) A handwashing communication intervention in Guatemala. Waterlines 13, 19-22.
Notes: This is a descriptive study and does not include data to support the author's conclusions. No follow-up papers have appeared on this programme. This severely limits the usefulness of the report

Isely,R.B. (1978) A community organisation approach to clean water and waste disposal in Cameroonian villages. Progress in Water Technology 11, 109-116.
Notes: This paper provides a useful discussions of the working of the water and sanitation committee. however there is a lack of data on impact, controls, baseline or statistical inference.

Isely,R.B., David,M., Gaston,B. and Sylvestre,M. (1988) A village takes its future in hand: Ekali1 (Cameroon), 1968-1982. In: Carlaw,R.B. and Ward,W.B., (Eds.) Primary health care: the African Experience. Volume two in a series of case studies in community health education, pp. 11-35. Oakland,Ca.: Third Party Publishing Company]
Notes: This provides an interesting case study of a community-based programme but there is no data on impact of the programme and it is mainly a descriptive study.

Katsha,S.e., Watts,S. and El-Katsha,S. (1994) Environmental health interventions in Egyptian villages. Community Development Journal 29, 232-238.
Notes: This study provides a good discussion of the process. While purporting to use a qualitative research method, the paper provides only a limited and superficial account of the impact. It is disappointing that there is no critical assessment of the empowerment outcome that the authors claim.

Khanom,K. and Leonard,R.C. (1989) A hygiene experiment in rural Bangladesh. Sociological Perspectives 32, 245-255.
Notes: No significance data, the health education intervention is very poorly described, no theory. The kind of paper that gives sociology a bad name!

Kweka,A.N. (1994) Adult education for self-reliance in community health education programmes - a case study from Tanzania. Adult Education and Development No. 42, 7-17; 1 tab., 7-17.
Notes: Lack of systematic evaluation procedure or impact data

Levert,L. (1995) Clean up your act - development theatre for water and sanitation. Waterlines 14, 27-31.
Notes: This is a good description of the use of drama in promoting sanitation and its evaluation with an audience response questionnaire. However there is no baseline to measure impact or even some assessment of audience sizes. The authors, themselves comment on the difficulty of scaling up their approach.

Madan,A., Varma,S.K. and Jain,V.C. (1996) Promoting personal hygiene through educational media. Indian Journal of Social Research 38, 133-141.
Notes: The usefulness of this study is severely limited by the lack of information on the content of the video and the measuring instruments used for evaluation.

Mahadik,V.J. and Mbomena,J. (1983) Impart of health education programme on knowledge, attitude and practice (KAP) of people in chlera affected areas of Luapula Province - Zambia. Medical Journal of Zambia 17, 32-38.
Notes: Lack of baseline and any description of the actual intervention makes it a very weak study and not suitable for Leeds HE Database

Menaruchi,A. (1986) Drinking-water and sanitation: a village in action. World Health Forum 7, 303-306.
Notes: In the absence of any discussion of research methodology or data/significance tests on attitudes and knowledge all that can be said from this study is that the number of latrines and storage jars increased and it is not possible to attribute this to the intervention .

Misra,K.K. (1975) Safe water in rural areas - an experiment in promoting community participation in India. International Journal of Health Education 18, 53-59.
Notes: This report is descriptive and contains no impact data

Muller,M., Sanchez,R.M. and Suswillo,R.R. (1989) Evaluation of a sanitation programme using eggs of Ascaris lumbricoides in household yard soils as indicators. Journal of Tropical Medicine & Hygiene 92, 10-16.
Notes: This is really an evaluation of the health impact of latrines - there is no educational content - it just compares households with and without latrines. It is of interest in that it shows the use of ascaris eggs as a marker.

Murda,A.A.-G. (1985) Evaluation of a health education programme in Tayba Qurashi Village, Central Sudan during 1983. Journal of Tropical Medicine & Hygiene 88, 111-113.
Notes: There is a lack of educational methodology, controls or statistical analysis.

Prins,A. (1984) Community participation in health action through structured problem solving: lessons learned in the socio-health program of the Togo Rural Water Project. Public Health Reviews 12, 322-331.
Notes: Lack of impact data has led to the rejection of this paper for including in the data-base. There is some interesting discussion and it may be worth re-considering its status and including it at some stage in the future as an example of 'process evaluation'.

Prins,A., Laughter,D. and Isely,R.B. (1988) Solving health problems through community action: health education in the Togo rural water and sanitation project. In: Carlaw,R.B. and Ward,W.B., (Eds.) Primary health care: the African Experience. Volume two in a series of case studies in community health education, pp. 113-142. Oakland,Ca.: Third Party Publishing]
Notes: This is a descriptive account of the implementation of a project at the mid-term evaluation point. No data is given on impact of the health education activities although a thoughtful account is given of the problems of implementation of community participation and village health worker training.

Riveron Corteguera,R.L. (1995) Strategies and causes of reduced infant and young child diarrheal disease mortality in Cuba, 1962-1993 [see comments]. Bull. Pan. Am. Health. Organ. 29, 70-80.
Notes: While valuable as a review of a large scale national programme, there is insufficient information presented to link declines in diarrhoea rates with programme inputs.

Sircar,B.K., Sengupta,P.G., Mondal,S.K., Gupta,D.N., Saha,N.C., Ghosh,S., Deb,B.C. and Pal,S.C. (1987) Effect of handwashing on the incidence of diarrhoea in a Calcutta slum. Journal of Diarrhoeal Diseases Research 5, 112-114.
Notes: This study is of interest in that it shows that a minimal intervention did not have any impact on diarrhoea and only affected dysentery of underfives. Thus it reveals the complexity of factors affecting diarrhoea. However no data is presented on whether the intervention community used the soap provided (though the soap was weighed and replenished). Also it is not clear what exactly the numbers in table 2 refer to.

Sörensson,M. (1995) Teaching by example - promoting hygiene and sanitation in primary schools. Waterlines 14, 23-25.
Notes: Strictly speaking this is not an intervention. However it is an extremely thoughtful discussion of the problems of improving water and sanitation in a group of schools.

Stanton,B., Black,R., Engle,P. and Pelto,G. (1992) Theory-driven behavioral intervention research for the control of diarrheal diseases. Social Science and Medicine 35, 1405-1420.
Notes: This provides a general discussion of theory but does not include data from the evaluation of an intervention study.

Steuart,G.W., Mbombo,A., Ngidi,M. and Philips,R. (1962) Sanitation changes in an African Community - A study of primary group education - part 2. Health Education Journal (USA) 20, 198-205.
Notes: This intervention has been excluded from the database because it falls outside the date criteria.

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15 Chronic diseases, substance abuse and mental health

Devi,R., Singh,M.M. and Walia,I. (1998) An effective manual on breast self-examination. World Health Forum 19, 388-389.
Notes: No details of the measuring instrument, raw data, controls or statistical analysis are provided.

Kiangi,G., Nissinen,A., Vartianen,E., Mtango,D. and Myllykangas,M. (1995) Access to health information on alcohol and tobacco among adolescents in Tanzania. Health Promotion International 10, 167-175.
Notes: This is not an evaluation of a specific health promotion programme but an assessment of pupils' understandings of health issues

Livingston,I.L. (1985) Hypertension and health education intervention in the Caribbean: a public health appraisal. [Review]. Journal of the National Medical Association 77, 273-280.
Notes: This is a general review and not an evaluation of a specific intervention

Perry,C.L. and Grant,M. (1991) A cross-cultural pilot study on alcohol education and young people. World Health Statistics Quarterly 44, 70-73.
Notes: The intervention methodology is described but it is a very brief report and data on impact is aggregated from the four participating countries which makes it difficult to ascribe the effect of the specific country programmes. This is disappointing as it is an unique programme which potentially could provided valuable insights into the impact of peer education on alcohol use.

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16 Miscellaneous health topics including primary health care, patient education, accident prevention/safety education

Agarwal,A. (1995) Mass Media and Health Promotion in Indian Villages. Psychology and Developing Societies 7, 217-236.
Notes: This is a cross-sectional study which seeks to draw some conclusions about influences on health behaviour and the role of media in general in shaping decisions. As such, it is not an evaluation of specific programmes. Data is not elicited about the impact of particular mass media activities so the results are quite general. There are no controls.

Al Dawood,K. and Mangoud,A.M. (1997) Assessment of health education outcomes among adults attending primary health care centres in Al khobar City, Saudi Arabia. International Journal of Health Education 35, 63-67.
Notes: This study is limited by lack of information on health education activity, baseline and controls.

Burghart,R. (1982) Health education in South Asia: an 'experiment' with itinerant medicine men. South Asia Research 2, 15-24.
Notes: A fascinating account of the work of different traditional healers. however, there is no systematic data on the impact of their work and it does not represent a formal intervention.

Clift,E. (1989) Social marketing and communication: Changing health behavior in the Third World. American Journal of Health Promotion 3, 17-24.
Notes: A generalised discussion which while referring to specific projects does not provide sufficient description of evaluation methodology an impact on them to enable an assessment of evidence.

de Sousa,I.C.F. (1995) Discussing women's reproductive health, religion, roles and rights: achieving women's empowerment. Convergence 28, 45-51.
Notes: There is a lack of detail on the qualitative analysis.

Dwiwedi,K.N., Tiwari,I.K. and Marwah,S.M. (1972) India - innovations in health education in rural schools. International Journal of Health Education 16, 100-107.
Notes: This is an interesting early school health education study which has been left outside the Leeds Database because it is pre-1975 and outside the timescale for inclusion.

Elkamel,F. (1995) The use of television series in health education. Health Education Research: Theory and Practice 10, 225-232.
Notes: An interesting descriptive account but no impact data.

Engelkes,E. (1990) Process evaluation in a Colombian primary health care programme. Health Policy and Planning 5, 327-335.
Notes: This paper presents some useful comments on the implementation of a primary health care programme. Whilst claiming to be an example of process evaluation, no information is provided of the different kinds of data-gathering that took place, there is no raw data presented. Whilst presenting evaluation findings, there is no detailed discussion either of the project or the data upon which those findings are based. There was no baseline information.

Hall,B. (1975) Conscientization by radio in Tanzania. IDS Bulletin 6, 95-105.
Notes: This paper is rejected because of the date criteria (1975 or earlier) and also because raw data on impact is not provided.

Heshmat,M.Y. (1975) Evaluating various forms of publicity. International Journal of Health Education 86-94.
Notes: This has been excluded from the Leeds Database on account of the age criteria of 1975 or less used for the database.

Ho,S.C. and Nam,A.C. (1980) Factors influencing the outcome of health campaigns: a case study in Singapore. International Journal of Health Education 23, 247-252.
Notes: This study is limited by lack of controls, baseline or statistical analysis.

Laoye,J.A. (1980) Selling health in the market place: the Araromi approach. International Journal of Health Education 23, 87-93.
Notes: This is a descriptive account of a very interesting community-based approach, however no data is provided on impact on the community.

Laverack,G., Esi Sakyi,B. and Hubley,J. (1997) Participatory learning materials for health promotion in Ghana - a case study. Health Promotion International 12, 21-26.
Notes: This does not contain information on impact.

Lefevre,F. (1995) The Sad Picture of Health: Analysis of a Billboard; O triste quadro da saude: analise de um out-door. Cadernos de Saude Publica 11, 506-510.
Notes: While an interesting analysis of a health communication, there is no data on impact on the community.

Malamah-Thomas,D.H. (1987) Community theatre with and by the people. The Sierra Leone experience. Convergence 20, 59-68.
Notes: descriptive account with little information on actual intervention and no impact data and no controls.

Ogbalu,A.I. (1993) Use of parents as a source of health information to primary five pupils in Onitsha (Nigeria). Journal of the Institute of Health Education (United kingdom) 31, 57-59.
Notes: Lack of information on sample sizes or statistical analysis limits the value of this study.

Poore,P.D. and Lloyd,T. (1984) Dua Dua Theatre: an experiment in health education. Trop. Doct. 14, 89-92.
Notes: While providing a useful description of school drama activities, no data on impact is provided.

Roberts,G. (1997) The Kadavu health promotion model, Fiji. Health Promotion International 12, 283-290.
Notes: This is an interesting descriptive account of a programme but insufficient details are provided of impact for it to qualify as a process evaluation

Rohde,J.E. and Sadjimin,T. (1980) Elementary school pupils as health educators: role of school health programmes in primary health care. Lancet 1, 1350-1353.
Notes: This provides a good description of the content of health education diarrhoea however the study is limited by the lack of controls and statistical analysis of data.

Simoni,J.J., Vargas,L.A. and Casillas,L. (1982) Medicine showmen and the communication of health information in Mexico, Michigan State University, College of Education, Non-formal Education Information Centre.
Notes: No data or statistical analyses are presented in this report to substantiate the claims - disappointing as this was a fascinating and creative programme.

Spector,P., Torres,A., Lichtenstein,S., Preston,H.O., Clark,J.B. and Silverman,S.B. (1971) Communication media and motivation in the adoption of new practices: an experiment in rural Ecuador. Human Organization 30, 39-46.
Notes: This study was carried out within the general framework of Communications of Innovation Theory to determine the relative effectiveness of various forms of mediated communication in introducing new practices in a developing nation. It has been excluded from the leeds Database because it falls outside the date criterion.

Stephens,T.T. and Oriuwa,C.L. (1999) Enhancing participation of women of child-bearing age in a literacy for health project in southeastern Nigeria. Trop. Doct. 29, 12-18.
Notes: While an interesting discussion on participatory processes, the only impact data presented is on participation in literacy sessions.

Thein,M.M. and Lee,J. (1993) Road safety education for schoolchildren. World Health Forum 14, 407-409.
Notes: . Minimal information is provided of the educational activities which took place alongside other measures such as improved road signs and pedestrian crossings. Casualty rates are provided of slightly injured and seriously injured children which fell between 1980 and 1989. However it is not possible to tell from the data which interventions were responsible. Also sources are not described or raw data/statistical tests provided.

Walt,G., Perera,M. and Heggenhougen,K. (1989) Are large-scale volunteer community health worker programmes feasible? The case of Sri Lanka. Social Science and Medicine 29, 599-608.
Notes: This study included interviews with 120 householders, in-depth dialogues with 20 householders and focus group discussions with groups in four villages. However the main thrust of the evaluation was on performance of village health workers. There was no baseline study. Information pointed to high levels of latrine ownership in one village and high stated contraceptive use but the data collected did not enable the contribution of the village health workers to this. The paper is therefore not considered appropriate for the Leeds Health Education Database.