Evaluating the effectiveness of utilizing traditional birth attendants for maternal and child health/family planning programs in the rural Philippines.
A pilot project was designed to measure the effectiveness of utilizing traditional birth attendants (hilots) as family planning motivators in the Philippines. A total of 492 hilots underwent a one-week training program in maternal and child health and family planning. Following the training, a quasi-experimental design was used to test the effects of training alone, training plus supervision, and the combination of training, supervision and a monetary incentive on family planning activities. In addition to these three program inputs, the type of training method was also assessed to determine its relationship on post-training knowledge scores and field performance. Analysis of the one-year program statistics indicated that a combination of training methods (lecture, audio-visual demonstrations, and role-playing) significantly increased both test performance and field performance. Hilots who received supervision recruited twice as many acceptors as hilots who received only the training input (p <.01). Adding a monetary incentive did not significantly increase the average monthly number of acceptors recruited. Cost effectiveness of the three experimental approaches are contrasted with each other as well as with the national program utilizing family planning motivators.
Morisky
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School of Public Health, University of California, Los Angeles.