Outcome evaluation of community health promotion intervention within a donor funded project climate in Papua New Guinea.
BACKGROUND
The Australian Agency for International Development (AusAID) funded Women and Children's Health Project sought to improve the health of women and children throughout Papua New Guinea between 1998 and 2004. The project utilised education, community development and health promotion interventions aimed to increase community support for the health of women and children.


METHODS
An outcome evaluation in 2006 investigated the long-term impact of the project using a multi-methods approach and covering 10 selectively sampled provinces, 19 districts and 93 communities. Qualitative data were collected from 175 interviews (national to village level) and 77 community discussions. Quantitative data from national, provincial and district levels were examined to attempt to validate findings.


RESULTS
The evaluation found new-health-knowledge initiated changes to lifestyle practices and improved physical health and social and economic well-being in villages where volunteers and staff had been trained. Factors influencing success were a health-motivated person acting as a catalyst for change, empowered leadership through new community governance structures, effective visual tools and village health volunteers linking community and rural health workers. Failure was attributed to poor understanding of community development, limited information sharing, a 'top down' approach to community development and weak community leadership.


CONCLUSIONS
The project's community health interventions improved the interaction between the community and health system, and influenced improved use of maternal and child health services. Evaluation suggests sustainable improvements in health can be achieved through community led and maintained activity.
Ashwell
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Northern Rivers University Department of Rural Health, Lismore, New South Wales, Australia. hashwell@bigpond.com.au
Barclay
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D001315:Australia; D002648:Child; D002669:Child Welfare; D003159:Community-Institutional Relations; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D008429:Maternal Welfare; D017063:Outcome Assessment, Health Care; D010219:Papua New Guinea; D012922:Social Change