'Outcome' usually refers to the long-term changes that may have occurred as a result of health education interventions. These long-term changes may include decreases in mortality, morbidity, the prevalence of disease, or the incidence of the health conditions being studied (Figure 16.6). Outcome evaluation involves an assessment of some of these measurable long-term outcomes or effects of your health education activities. Surveys may be conducted after three or five years, and they may be difficult to conduct. This type of evaluation may be conducted by external agencies.
Mrs Abebech is a Health Extension Practitioner in Akaki. She has conducted health education sessions for ten mothers in a nearby village on the subject of family planning. She had a series of discussions with them. During these discussions she showed them different family planning methods. At the end of the sessions she evaluated her activities.
Identify which of the following are process, impact or outcome types of evaluation and say why.
- Asking about the mother's knowledge and understanding about family planning methods at the end of each session.
- Asking the mothers their beliefs about contraceptives after the final session.
- Assessing for herself how the discussions had been conducted.
- Asking the mothers whether the messages about contraception had been acceptable to them.
- Assessing whether the mothers were more interested in the discussion method than the demonstration method.
a and b are examples of impact evaluation. This is because changes in knowledge and beliefs are two of the immediate impacts (effects) of health education.
c, d and e are all examples of process evaluation. This is because they involve assessing how well the discussions went and they look into the process of the sessions.