3203.0: Monday, November 13, 2000 - 5:30 PM

Abstract #15463

An evaluation of the impact of village-based primary health care workers on child mortality in The Gambia

William B. MacLeod, ScD, Health Office, Harvard Institute for International Development, 14 Story Street, Cambridge, MA 02138, 617-495-9791, wmacleod@hiid.harvard.edu and Allan G. Hill, PhD, Department of Population and International Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Objectives. This study assessed the decline in child mortality in rural settlements before and after the establishment of a village-based Primary Health Care program.

Methods. Poisson regression analysis was applied to an analysis of the Gambian 1983 and 1993 censuses, which compared the decline in child mortality in different classes of PHC settlements in the period between the two censuses: before and after implementation of PHC.

Results. Childhood mortality declined in rural Gambia throughout the period under study. The analysis shows that under-five mortality declined faster in settlements with community health nurses and village health workers than in settlements without these personnel.

Conclusions. Under-five mortality has declined markedly in The Gambia in the past 30 years. This decline has occurred against a backdrop of minor improvements in living standards and moderate increases in educational levels. Contrary to previous evaluations in The Gambia, the evidence from this study showed that under-five mortality declined slightly faster in settlements with community health nurses, village health workers, and trained traditional birth attendants than in settlements without these personnel. This points to the role that modest, low-cost, village-based primary health interventions played in the decline.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Identify the components of the village-based primary health care program in The Gambia. 2. Describe how routine census data can be used to estimate child mortality in developing countries. 3. Discuss the challenges in assessing the impact of health programs on the health of a population

Keywords: Child Health, International Public Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA