Health for all?: evaluation and monitoring in a comprehensive primary health care project in Colombia
Gespeichert in:
| 1. Verfasser: | |
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| Format: | Buch |
| Sprache: | Dutch English |
| Veröffentlicht: |
1989
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| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Amsterdam, Univ., Diss. |
| Beschreibung: | XXV, 205, XXIII S. Ill., graph. Darst., Kt. |
| ISBN: | 9068320270 |
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Datensatz im Suchindex
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| adam_text | Contents Abbreviations Page xv List of tables xvi List of figures xix List of photographs xxi Preface xxii Acknowledgements xxiv Section 1: General introduction 1 Chapter 1. Primary Health Care 3 1.1 1.2 1.3 1.4 The concept, its history and international context Primary Health Care in Colombia The Convênio Colombo-Holandés health project The Rural Health Programme in Chocó Province 1.4.1 The project 1.4.2 The CIMDER methodology 1.4.3 Adaptations to the CIMDER methodology in Chocó 1.4.4 Population participating 1.4.5 Expenditure 1.4.6 Health services support 1.4.7 Financial resources of the health services Chapter 2. Evaluation and monitoring 2.1 2.2 2.3 2.4 2.5 2.6 3 5 б 7 19 Evaluation 2.1.1 Aspects of evaluation 2.1.2 Quality criteria of evaluations 2.1.3 The systems approach Monitoring Evaluation of health services Evaluation of Primary Health Care 2.4.1 The PHC system 2.4.2 Special characteristics of comprehensive PHC evaluation 2.4.3 Utilization and coverage in PHC Evaluation of Primary Health Care in Colombia Evaluation and monitoring in the Chocó PRS vu 19 23 23 25 28 28
Chapter 3. Literature review 31 3.1 WHO on evaluation and monitoring in PHC 31 3.2 Other literature on evaluation and monitoring in PHC 32 3.3 Other evaluation in the social sector 34 3.4 Evaluation in health projects 34 3.5 National health information systems 35 3.6 Evaluation of health services in Colombia 35 3.7 Health surveys 35 Chapter 4. Justification, objectives and methodology of this study 36 4.1 Justification 36 4.2 Background to the study 36 4.3 Study objectives 37 4.4 Methodology used 37 Section 2: Background 39 Chapter 5. Colombia 41 5.1 Location, geography and climate 41 5.2 History 41 5.3 Population 43 5.4 Economics 43 5.5 Education 43 5.6 Administrative and political structure 43 5.7 Health 43 5.8 The Colombian health system 44 Chapter 6. Chocó Province 47 6.1 Location, geography and climate 47 6.2 Population 47 6.3 6.4 Resources History 47 48 6.5 Economy 48 6.6 Communication 48 6.7 Health 6.8 Environmental sanitation 6.9 Health resources 49 49 49 Chapter 7. The Atrāto area 7.1 General information 7.2 Health services 7.3 Environmental sanitation Population 7.4 57 57 57 57 ς7 viii
Section 3: Methods 61 Chapter 8. Introduction 63 8.1 8.2 8.3 Background to the morbidity survey (1982-83) Background to the adapted WHO review (1984) Background to the participatory evaluation (1985) Chapter 9. The CIMDER monitoring system 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 Objectives Techniques and instruments used Human resources Data collection Analysis Supervision Feedback Costs Objectives of the survey Techniques and instruments used for data collection Sample selection Pilot survey Human resources involved Community organization and motivation Data collection Analysis of data Feedback Costs Chapter 11. Method of adapted WHO reviews 11.1 11.2 11.3 11.4 11.5 11.6 11.7 65 65 65 67 68 68 68 68 68 Chapter 10. Method used in the cross-sectional survey 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 63 64 64 Objectives Adaptation of WHO protocols 11.2.1 Task analysis of promotoras 11.2.2 Task analysis of auxiliary nurse in PHC 11.2.3 Task analysis of village committees Instruments used for data collection 11.3.1 Home visits 11.3.2 Promotora (micro health post) 11.3.3 Community 11.3.4 TBAs 11.3.5 Health Centre activities Pilot review Sample selection Human resources involved Data collection 11.7.1 Evaluation of the promotora 11.7.2 Evaluation of people’s knowledge of health ix 75 75 75 78 79 79 79 80 80 83 83 84 84 84 85 87 87 87 87
Evaluation of community participation Evaluation of construction, use and maintenance of water supply and latrines 11.7.5 Evaluation of health centre activities 11.8 Analysis 11.9 Feedback 11.10 Costs 11.7.3 11.7.4 89 89 89 90 Chapter 12. Participatory evaluation 12.1 12.2 Objectives Techniques and instruments used 90 90 12.3 12.4 Resources Sample selection 90 90 12.5 12.6 Analysis Feedback 91 91 12.7 Costs 91 92 Chapter 13. External evaluations 92 13.1 Objectives 13.1.1 General objectives 13.1.2 Specific objectives 13.2 Method 13.3 Human resources involved 13.4 Sample selection 13.5 13.6 93 93 93 93 94 Feedback Costs Section 4: Results 95 Chapter 14. CIMDER system monitoring results 97 14.1 97 Programme population 14.2 14.3 Mortality Morbidity 14.3.1 Incidence 14.3.2 Morbidity of pregnancy, labour and postnatal period 14.3.3 Severity of morbidity 14.3.4 Case fatality 14.4 Nutritional status 14.5 Coverage 14.5.1 Vaccination coverage 14.5.2 Family planning coverage 14.5.3 Coverage of antenatal care, delivery attendance and postnatal care by a trained person 14.5.4 Water supply coverage 14.5.5 Improved systems of excreta disposal 14.5.6 De-worming coverage 14.5.7 Home visits 14.6 Changes in health behaviour 14.6.1 Home hygiene x 98 98 102 102 106
14.6.2 Garbage disposal 14.6.3 Treatment of drinking water 14.6.4 Breastfeeding 14.7 Utilization of health resources 14.7.1 Consultation for illness 14.7.2 Consultation for morbidity of pregnancy, labour and postnatal period 14.7.3 Attendance at labour 14.8 Community organizations and intersectoral activities Chapter 15. Results of the cross-sectional survey 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 Description of the sample villages Age and sex of the sample population Socio-economic conditions 15.3-1 Heads of households by sex 15-3-2 Women and the economy 15.3.3 Land ownership 15.3.4 Education Environmental sanitation Infant mortality rate Fertility Morbidity pattern 15.7.1 Morbidity by sample village 15.7.2 Morbidity by age group and sex Utilization of curative services Comparison between programme and control villages 15.9.1 Intestinal parasitosis 15.9.2 Diarrhoea 15.9.3 Vaccination coverage and vaccine-preventable diseases Chapter 16. Results of the adapted WHO reviews 16.1 16.2 16.3 16.4 16.5 Selection, training and activities of promotoras 16.1.1 Profiles 16.1.2 Knowledge of health problems 16.1.3 Referral 16.1.4 Community activities and acceptability of the promotoras 16.1.5 Promotoras’ administration 16.1.6 The micro health post 16.1.7 Home visits by promotoras 16.1.8 Relation between promotoras’ profiles and their activities Traditional birth attendants and traditional healers 16.2.1 Traditional birth attendants 16.2.2 Traditional healers Community participation 16.3.1 Health committees 16.3.2 Government institutions’ response to meetings with villagers 16.3.3
Community awareness 16.3.4 Water supply committees Health knowledge and practices 16.4.1 Health knowledge 16.4.2 Health practices Maintenance of water supply and latrines 108 109 109 110 110 118 119 120 120 143 145 150 150 152 152 153 153
16.6 Utilization of health resources 16.6.1 Utilization of curative PHC services 16.6.2 Utilization of antenatal, postnatal and delivery services 16.6.3 Utilization of water supply 16.6.4 Utilization of vaccination services 16.6.5 Utilization of family planning methods 16.7 Evaluation of Health Centre support 16.7.1 Supplies 16.7.2 Feedback on referrals 16.7.3 Supervision 16.7.4 Visits by sanitary technician 16.7.5 In-service training 16.8 Work and resources of the health centres 16.8.1 Resources 16.8.2 Work of the health centres Chapter 17. Results of the participatory evaluation 17.1 17.2 17.3 17.4 17.5 Medical care 17.1.1 Vaccination 17.1.2 Referral 17.1.3 Antenatal care 17.1.4 Family planning Environmental sanitation 17.2.1 Water supply 17.2.2 Disposal of excreta 17.2.3 Disposal of garbage Community participation І7.З.І Traditional medicine Training and supervision of promotoras Health education 154 155 156 158 158 158 159 I6O 160 Chapter 18. Results of the external evaluations 18.1 General findings 18.1.1 Relevance of the programme 18.1.2 Progress in relation to objectives 18.1.3 ‘Impact’ 18.1.4 The concept of PHC as defined by the programme 18.1.5 Organization and administration 18.1.6 Financial aspects 18.2 Evaluation of programme components 18.2.1 Medical care 18.2.2 Environmental sanitation 18.2.3 Training of promotoras 18.2.4 Supervision 18.2.5 Community participation 18.2.6 Monitoring system l6l Section 5: Discussion and conclusions 165 Chapter 19. Discussion of the results 19.I l6l І6З 167 Introduction 167 Xll
19.2 19.3 19.4 19.5 19.6 19.7 Input data 19.2.1 Community input 19.2.2 Official health services and project input 19.2.3 Other sectors and resources 19.2.4 Summary of input data Process data 19.3.1 Community process 19.3.2 Process at official services and project level 19.3.3 Conclusions from process data Output data 19.4.1 Coverage 19.4.2 Community organization and intersectoral activities 19.4.3 Improvements in health behaviour 19.4.4 Conclusions from output data Outcome data Final conclusions on the PRS and PHCin general Recommendations regarding the PRS,PHC inColombia and PHC in general Chapter 20. Discussion of methods 1б7 174 176 177 178 181 20.1 20.2 Introduction The CIMDER monitoring system 20.2.1 Reliability, validity and relevance of data 20.2.2 Costs 20.2.3 Feedback 20.2.4 Utilization of the information 20.2.5 Side-effects 20.2.6 Possible improvements 20.3 The cross-sectional survey 20.3.1 Reliability, validity and relevance of data 20.3.2 Costs 20.3.3 Feedback 20.3.4 Utilization of the information 20.3.5 Side-effects 20.3.6 Possible improvements 20.4 Adapted WHO review method 20.4.1 Reliability, validity and relevance of information 20.4.2 Costs 20.4.3 Feedback 20.4.4 Utilization of the information 20.4.5 Side-effects 20.4.6 Possible improvements 20.5 The participatory evaluation 20.5.1 Reliability, validity and relevance of information 20.5.2 Costs 20.5.3 Feedback 20.5.4 Utilization of the information 20.5.5 Side-effects 20.5.6 Possible improvements 20.6 External evaluations 20.6.1 Reliability, validity and relevance of information 20.6.2 Costs 20.6.3 Feedback
ХШ 181 183 189 195 I97 iç g
20.6.4 Utilization of the information 20.6.5 Side-effects 20.6.6 Possible improvements Chapter 21. Towards a framework for evaluation in PHC 21.1 21.2 Baseline information Monitoring 200 200 201 21.3 Evaluation 21.4 Supervision 21.5 Conclusion 21.6 Suggestions for future evaluationofthe PRSin Chocó 21.7 Applicability of the above design to otherPHC projects 202 203 203 204 204 Annex 1 I Annex 2 Π References III Summaries XI About the author XXIII xiv
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| spelling | Engelkes, P. E. Verfasser aut Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia by P. E. M. Engelkes 1989 XXV, 205, XXIII S. Ill., graph. Darst., Kt. txt rdacontent n rdamedia nc rdacarrier Amsterdam, Univ., Diss. Eerstelijnszorg gtt Gezondheidszorg gtt Projecten gtt Gesundheitswesen Public health Colombia Primäre Gesundheitsversorgung (DE-588)4196757-4 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content Primäre Gesundheitsversorgung (DE-588)4196757-4 s DE-604 Digitalisierung UB Bamberg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=003197174&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Engelkes, P. E. Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia Eerstelijnszorg gtt Gezondheidszorg gtt Projecten gtt Gesundheitswesen Public health Colombia Primäre Gesundheitsversorgung (DE-588)4196757-4 gnd |
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| title | Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia |
| title_auth | Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia |
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| title_full | Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia by P. E. M. Engelkes |
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| title_full_unstemmed | Health for all? evaluation and monitoring in a comprehensive primary health care project in Colombia by P. E. M. Engelkes |
| title_short | Health for all? |
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| title_sub | evaluation and monitoring in a comprehensive primary health care project in Colombia |
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