|Education for Health (WHO, 1988, 274 p.)|
|Chapter 3: Planning for health education in primary health care|
If you have given time and effort to a project, you will want to know if it has been successful. In judging success, it is not enough simply to say 'we were very successful', or 'we had some success', or 'we failed'. If possible, a specific measure of the amount of success is needed.
Checking on the progress made
Observation, interviews, and records will supply information for evaluating a programme.
It is important to select the method (or methods) most appropriate (or the group concerned. It is also important to use a mixture of methods that will help people to understand better and to remember.
To take an example: it has been planned that the funds for the water supply project will be raised by the 12th week. If not enough money has been collected by that time, then something is wrong. The planning group must start to check and find the cause. Maybe the neighborhood leaders were not adequately informed about how to organize fund-raising. Maybe it was a bad time of year for people to donate money because the harvest was not yet in.
If the plans were to dig four wells within six months, but only one is under way by the 17th or 18th week, then the group should immediately try to find out why. Maybe more materials are needed than originally planned. Maybe some of the labourers misunderstood their instructions.
Problems should be corrected as soon as they are seen.
By the end of the educational activities, you should be able to measure their success by counting how many people are behaving according to the original objectives: is this number more than before the programme started?
Use observation to check results. With community wells, for instance: is there evidence that they are maintained hygienically? Are people keeping them covered? Are they using clean buckets for gathering water? Are they storing the water in clean, covered containers at home? Are people still going to the stream to fetch water?
If people are using the wells hygienically and storing water safely at home, the educational objectives of the programme have been achieved.
As for the health objectives, there should be a decrease in the amount of waterborne disease. Depending on the type of disease, it may take several months for this to show. If a reduction in illness does not occur, test the well-water and look for other sources of contamination. If, in fact, waterborne disease is decreasing, then the programme has been successful.
Learning from evaluation
At the end of the programme, a final meeting can be held to discuss how far the programme has succeeded. Two main questions must be answered:
1. Did the action go as well as planned?
- Did people participate?
- Were resources available on time?
- Did people gain new skills and learn from the programme?
2. Was the problem eliminated or reduced? Using the example of schistosomiasis:
- Do people now have access to safe water supplies?
- Are people disposing of faeces and urine in a safe manner?
- Are fewer people suffering from the disease now than before the programme started?
Discussing such questions will help people evaluate and learn from their programmes. We can obtain the answers to these questions in the way in which we originally gathered information about the community when we started planning through observation, interview, and records. Compare information gathered before the programme started with information collected after it ended.
Even if the programme did not turn out as desired, a meeting should still be held to find out why. A review of the timetable will help show if every person carried out his or her duties.
Questions such as these might help:
Were there any unreported difficulties earlier in the programme? Did other community events disturb or distract people from participating in the action? Were there any disagreements among community members that stopped them working together? Was the time set for the programme unrealistic? Were the activities chosen inappropriate to the local culture?
Once sources of difficulty have been found, the group can decide if it wants to try again. Learning can come from mistakes as well as from successes. It is a hopeful sign if people can sit down maturely and work out the cause of a problem. At such times, a health worker can provide much-needed support and encouragement. With new knowledge about the problem, the group will know how to plan a better programme in the future.