E-drug: Teaching mothers to provide home malaria treatment (cont)
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An on-going project I have been involved in is to develop a data-base
of health education interventions in developing countries that
provide evidence of impact on individual and communities. This
project is at quite an advanced stage and we have over 500 studies in
the data-base covering many health topics and using a wide range of
educational methods including
clinic-based, community-based, folk media, mass media and
school-based. We are receiving help from WHO to develop it so that
it might eventually go in their health promotion web-site. DFID are
supporting the publication of a book based on the data-base that will
draw out lessons learned about methods.
As such I have reviewed the Kidane and Morrow Lancet paper for
inclusion into the data-base. It certainly is a significant and
welcome publication for demonstrating health impact and the authors
( and the participating health workers and communities also!) should
be congratulated. I will be including it in my data-base.
Notwithstanding its value, there are some shortcomings which I am
raising because it shows some of the problems I face trying to
develop evidence-based practice for health education and health
promotion.
The amount of description of the educational methodology used both
for training the mother coordinators and the mothers is very limited.
No information is given in the abstract but in the text there is a
sentence that refers to the use of 'special pictorial treatment
charts' but that is all the information provided. The impact data
consists of showing that the number of deaths attributed to malaria
among children in the intervention community is lower. However, it
would be good to have some supporting information to show that the
reason for differences in childhood deaths was a result of improved
home case management by mothers arising from exposure to the
educational programme.
Shortcomings such as the above are fairly typical of papers published
in epidemiology and tropical medicine journals which are not usually
very interested in details on educational method. I am sure that the
authors have more information on the educational methods used and on
supporting evidence for impact of the education on practices. I hope
they will publish
it so that we can learn the operational lessons from their programme
and replicate it in other settings.
John Hubley
Dr John Hubley, 21 Arncliffe Road,
Leeds LS16 5AP, United Kingdom.
tel. 0113 2755486; Fax 0113 2305224
e-mail: john@hubley.co.uk
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