The purpose of evaluation in health education
Evaluation will help you to determine how effective you are in achieving your objectives (Figure 16.3). Effectiveness refers to the extent to which you have achieved your goals and objectives. While planning your health education work, you should have set down certain learning and behavioural objectives – and by using the process of evaluation you will be able to assess whether you have achieved these objectives.
Evaluation should be able to help you determine whether you have used your resources efficiently while achieving your objectives. Efficiency means the extent to which you have achieved your objectives with the available amount of resources. In other words, it refers to the proper utilisation of resources when achieving your health education objectives.
The following activity shows how effectiveness and efficiency are related to each other. It is important to recognise these terminologies so that you can keep your activities effective and efficient. Activity 16.1 will help you to understand the difference between them. Read Activity 16.1 and then answer the questions that follow it.
Activity 16.1
Genet and Bontu are Health Extension Practitioners. They are working at the Ayinew health post. Both of them visit 15 households each week. During her visits, Bontu always advises the family members on several health issues, like family planning, personal hygiene, housing conditions, use of the toilet, and how to keep utensils clean. However, Genet always teaches the families about only one health issue on each visit, and she needs 3 more visits than Bontu to achieve the behavioural changes in health promoting practice.
Who is more effective in achieving health promoting practice among family members, and why? Who is more efficient in achieving health promoting practice among family members? Why?
Comment
Both are effective because they achieved changes in health promoting practice. However, Bontu is more efficient than Genet because she uses fewer resources (visits) to achieve the same objective.
Evaluation helps you to improve your health education practice by learning from your successes and also understanding and changing any mistakes you may have made.
If you evaluate your activities, you will learn which of your health education methods work and which might need some adjustment. Evaluation should be conducted at the end of all your health education activities. For example, if you planned to increase the number of households who use bed nets properly in your village from 40 to 80 within a six month period, you should evaluate how many households are using the nets after six months. Evaluation can also be conducted by external bodies who may not have been involved in the health education implementation itself. If you evaluate your own work, you may over-appreciate your performance and underestimate the weaknesses. However, this does not mean that you should not evaluate your activities; rather, that you should take care to avoid such bias.
Evaluation is different from monitoring because it can only be done after a certain time, and requires more thorough investigation. It can be conducted by independent evaluators. Moreover, evaluation involves judgment — whereas monitoring assesses progress in implementation of ongoing activities, and it does not involve judgments.
In Study Session 15, you learned about monitoring your health education activities. You may want to re-read it before you continue to answer this question, in order to remind yourself about monitoring. After you have done this, think about what you would say are the differences between monitoring and evaluation? Briefly describe these differences.
Evaluation involves judgment of the outcomes of an activity, whereas monitoring does not involve judgment of the achievement. In monitoring, you do not say whether the achievement is good or bad. You simply check the progress and identify if a problem has been encountered. Evaluation is usually not a part of routine health education activities, whereas monitoring is an ongoing activity. However, evaluation is conducted at the end of a programme of activities. Evaluation may be conducted by an external body, whereas monitoring is usually conducted by those who carry out the activities.