Methods for the evaluation of a health intervention in developing countries: the case in the Arsi region, Ethiopia
Mele, A.; Materia, E.; Rosmini, F.; Stazi, M.A.; Pasquini, P.
Annali Dell'istituto Superiore di Sanita 27(2): 325-330
1991
ISSN/ISBN: 0021-2571 PMID: 1755587 Document Number: 381693
The Arsi region in Ethiopia has a population of 2 million who are served by 2 hospitals, 7 health centers (HCs), and 82 health stations (HSs). In 1988, a primary health care program was launched to improve health care by restructuring the instrumentation of HCs, HSs, and health posts HPs, by strengthening maternal-child health (MCH) care with UNICEF support of an expanded program of immunization. In villages, community health agents (CHA) provide primary care for the sick as well as information on hygiene and sanitation in collaboration with traditional birth attendants (TBAs). The health indicators chosen for the study were: overall mortality, child mortality for ages 1-4, sudden illness, utilization of health care, and vaccination coverage. In the first year, child mortality was calculated indirectly by using the technique of Brass. The estimated annual birth rate was 43/1000, the mortality rate was 19/1000, and the child mortality rate was 149/1000. 80 villages with an average population of 1500 each had about 5000 births a year. It was hypothesized that child mortality was 130/1000 in those villages that received minor health care and that a reduction of 20/100 could be achieved if 40 villages were completely covered by health care. Data collection regarding health indicators, sanitation, and household economics was envisioned for late 1989 and 1990 by student interviewers and CHAs. A quarterly demographic bulletin was issued by the Regional Epidemiological Office that monitored field work and checked data for quality. Periodic meetings of CHAs were held for problem-solving. the large nonhomogeneous population and inaccessible terrain posed most of the problems and necessitated a large staff for data collection and continuous supervision.