Professional Documents
Culture Documents
By Brian M. Stickier
W. Alan Davis (1987)
2nd Edition (1994)
3rd Edition (2000)
Evaluation Approaches
Sl . Approach Emphasis Focusing Issues Evaluator’s
No. role
1. Experimental Research What effects result from Expert/Scientis
design programme activities and ts
can they be generalized.
Plan for
(a)Delphi technique :
Individuals rank their responses to a numerical scale and provide at times explanations for that.
After tabulation of all participants responses again the respondent is asked to change his options or stick
to it with explanations. The procedure is repeated to point of a consensus or diminishing returns.
(b)Q-sort or pile-sorting :
A list of items on cards and numbered. Each individual is to sort the cards into piles as per a criterion
under a structured instruction. Then the process is repeated to get a consequence of the group on
categorization.
1st researcher Options / 2nd – complete list of group responses / ranking of options by individual members
or a note / explanations by facilitator / and consensus approach is arrived at Health Education, a new
Approach.
HEALTH EDUCATION – A NEW APPROACH
By L. Ramachandran & T. Dharmaligam.
Demographic Socio-psychological
Perceived benefit of perceived action –
personality, Peer group, social
(minus) perceived barrier to preventive
classes’ variables
action
1. Diagnostic studies
2. Action oriented studies or operational Research
3. Evaluation or Assessment Studies
4. Cost-benefit or effectiveness studies
5. Developmental studies pertaining to educational aids or methods,
training modules, implementation strategy etc.
6. KAP studies – Baselines & End line
7. Communication Studies
8. Evaluation & impact Studies
Research Studies must include
1. Observation of problems or events on a phenomenon.
2. Description and formulation of problems
3. Formulation of hypotheses and strategies for the solution
of problems.
4. Formation of a research design and decision of type of
data to be collected – Qualitative or Quantitative etc.
5. Date collection
6. Data processing and Analysis
7. Interpretation of findings
8. Report writing
QUALITATIVE RESEARCH DESIGNS
Themes:-
1. Naturalistic Enquiry
2. Inductive analysis
3. Direct program contact
4. Holistic perspective
5. Dynamic / Developmental perspective
6. Case studies
SAMPLING
1. Extreme or deviant case sampling
2. Maximum variation sampling
3. Homogeneous sampling
4. Typical case sampling
5. Critical case sampling
6. Criterion sampling
7. Confirmatory and disconformities case sampling
8. Political case sampling
9. Snowball or chain sampling
10. Convenience sampling
11. Opportunistic sampling
Triangulation or check and balance in
monitoring
1. Data triangulation
2. Investigator triangulation
3. Methodological triangulation
4. Theoretical triangulation
STRATEGIES
1). Pure Hypothetical – Deductive approach to Evaluation :
Experimental Design, quantitative data and statistical analysis (Quantitative).
2). Pure qualitative strategy :
Naturalistic inquiry, qualitative data and content analysis (Qualitative)
3). Mixed form: More Qualitative, less quantitative)
Experimental Deign, qualitative data collection and content analysis.(More
Qualitative, less quantitative)
4). Mixed form :
Naturalistic inquiry, qualitative data collection, and statistical analysis.(More
qualitative, less quantitative)
5). Mixed form:
Experimental design, qualitative data collection and statistical analysis. (Less
qualitative ,more quantitative)
6). Mixed form :
Naturalistic inquiry, quantitative measurement and statistical analysis. (Less
qualitative. more quantitative)
Tools / Techniques generally used
1. Observation
a) Participant (a) covert
b) Non-participant (b) covert
2. In depth interviews.
c) The informal conversational interview
d) The general interview guide approach
e) The standardized open-ended interview
f) Closed quantitative interview
Question types:
1. Experience / Behaviour questions
2. Opinion / Belief questions
3. Feeling / sentimental questions
4. Knowledge questions
5. Practice questions
6. Sensory questions
7. Background / Demographic questions
a) Case analysis
b) Content analysis
c) Inductive analysis
d) Logical analysis
Validation / verification
a) Causes
b) Effects or consequences
c) Relationships or net working
d) System study
Care studies to be included as such
1. Extreme cases
2. Typical cases
3. Negative cases
4. Rival / opposite cases
Block data of Harichandanpur
(Keonjhar District)
W.H.O. has developed a new index namely DALYs (disability Adjusted Life Years)
Rates of malnutrition among women and girls are higher than men and boys in
the same age group.
Due to insufficient care during antenatal / natal, post natal periods the woman
suffer from malnourishment resulting in Anemia.
I.C. M.R. Study
95% girls between 6-14 years in Kolkata are anemic
70% Delhi and Hyderabad
20% Chennai
More than 60% women suffer from Anaemia in India. Diet restrictions during
pregnancy and lactational stages further deplete the nutritional intake of
women resulting in Anaemia.
Malnourishment leading to Anaemia is not a result of poverty but more a result
of discrimination by gender.
Anaemia not only depletes physical resistance to disease but also results in
failure to achieve genetic potential in physical growth and development.
This has serious implications on work performance as well as reproductive
success, and also affects the next generation through low birth weight and poor
growth and development of the children that these women bear.
Higher loss of pregnancies as foetal wastage and among the children as deaths
in childhood encourages higher fertility resulting in further depletion of the
health of women.
Poor performance in maternity and childbirth results in other health problems
implying perpetuations of poor quality of population at each generation.
Dr. Gopalam, the internationally known nutritionist says that family planning
cannot be substitute for better health programmes. Current population, control
programmes that concentrate on the size (quantity) of the population
neglecting its quality, therefore, needs to be resolved seriously.
Women in tribal areas take longer duration and work very hard to fetch food,
fule ,water and fodder. It auguments their problems and results in Anaemia.
Technological improvements mostly benefited the man’s job rather than the
women’s job rural / tribal areas. So many of these conditions are exacerbated
by malnutrition, anaemia and child bearing.
Mal-nutrition unequal access to health care, adverse sex ratio, faulty family
planning strategy professional prejudices and minimized role of women and
gender gap in health and survival, women’s status in Indian society add to the
health problems of women and during pregnancy and /or lactations they are
exposed to poor health status and susceptible to anaemia. Control may be
difficult unless and until these above factors are taken care of.
Professional Prejudices:-
Instead of 13:1 ratio of Nurse to Doctor is India it should be ideal as 3:1. The
ANM’s low work status, money, recognition, job satisfaction, monitory and
labour creates problems for them and as mothers and wives they are also
burdened with work. State policies to minimize the population growth through
ANMs to work only for Women (the only target) creates an impossible took
assignment foe Women in the community.
ANAEMIA
(Text Book of SPM JE.park/K.Park, pp-340)
Due to Iron Deficiency
3 stages of Iron deficiency have been descried:-
(a)1st stage characterized by decreased shortage of iron without any other, detectable
abnormalities.
(b)An intermediate stage of ‘Latent Iron deficiency’ i.e. iron stores are exhausted but anaemia has
not occurred as yet.
Its recognition depends upon measurement of serum feritin levels. The percentage saturation of
transferring falls from a normal value of 30% to less than 15%.
This stage is the mostly prevalent stage in India.
(c)The 3rd stage is that of overt iron deficiency when there is a decrease in the concentration of
circulating haemoglobinic due to impaired hemoglobin synthesis.
The end result of iron deficiency is Nutritional anaemia which is not a disease
entity. It is rather a syndrome caused by malnutrition in its widest sense.
Besides, Anaemia, there may be other functional disturbances such as
impaired cell mediated immunity, reduced resistance to infection, increased
morbidity and mortality and diminished work performance.
Nutritional Anemia (P-351)
Nutritional Anaemia is a disease syndrome caused by malnutrition in its widest sense.
It has been defined by WHO as “a condition in which the hemoglobin content of
blood is lower than normal as a result of a deficiency of one or more essential
nutrients, regardless of the cause of such deficiency. Anaemia is established of the
hemoglobin in below the cut off points recommended by WHO. By far the most
frequent cause of Nutritional Anaemia is iron deficiency and less frequently folate or
vitamin B12.
The problem:-
INDIA:
Iron deficiency anemia is a major nutrition problem in India and many other
developing countries. In addition, many subjects have iron-deficiency without
anaemia. The incidence of anaemia is highest among women and young
children, varying between 60 to 70%. Recent surveys indicate that a rural
India anaemia is much more wide spread than hitherto believed, even among
men.
Iron deficiency can arise either due to inadequate intake or poor bio-
availability of dietary iron or due to excessive losses of iron from the body.
Although most habitual diets contain seemingly adequate amounts of iron,
only a small amount (less than 5%) is absorbed. This poor bio-availability is
considered to be a major reason for the widespread iron deficiency. Women
lose a considerable amount of iron especially during menstruation. Some of
the other factors leading to anaemia are malaria and hook worm infestations.
In addition mothers who have born children at close intervals became
anaemia due to the additional demands of the rapid pregnancies and the loss
of blood in each delivery.
In some areas of India, it has been shown that folate deficiency anaemia affects
25 to 50% of pregnant women attending hospital clinics, present evidence
suggests that a high prevalence of folate deficiency anaemia in pregnancy is a
universal phenomenon and is not associated simply with the economically
under privileged.
Detrimental effects:-
1. Risk of maternal and foetal mortality and morbidity (In India 20-40% of
maternal deaths)
2. Cause or aggregate infectious parasitic diseases like malaria or other worm
infestations
3. Impairment of maximal work capacity (specifically to women) reducing the
income levels of households.
Interventions
(II)Short term measures (a) Iron and folic acid supplementation (b)Iron
fortification ( All these are short-term measures)
(c)Other strategies like (Long term measures)
i. Changing of dietary habits
ii. Control of parasites
iii. Nutrition Education