Egypt
Monitoring and Evaluation
Activity Dates
2004-2007
Activity Summary
 The goal of research and monitoring efforts is to assess the reach and impact of the CHL program activities on family members’ values, attitudes, intentions, and health competency leading to life-stage appropriate health behaviors, as well as on demand for and utilization of health information and services. Health behaviors will be monitored within each life stage and health competency will be measured at the individual, family and community level.
At the community level, important aspects of health competency include (1) the capacity of community members, leaders, and institutions to plan and carry out decentralized participatory health communication programs, (2) collaboration among public and private sector agencies, and (3) partnerships between the community and service delivery systems. A combination of data from community members, community leaders, and service providers will be needed to assess these issues.
The combination of methods described below will allow attribution of measured changes to media-based, private sector, and community-based interventions.
Study Methods
Baseline Survey
In Year 1 of the project population-based household/community surveys were conducted in 2- 7 villages (with a total population of approximately 60,000) in Minya Governorate prior to and after the communication interventions. As many as seven villages will be intervention villages with a possible two control villages. A panel design was used to achieve maximum sensitivity in detecting and attributing change due to intervention activities.
Baseline measures (Wave 1) were used to inform the design of program interventions, as well as for impact assessment purposes. Furthermore, qualitative research was conducted to clarify any unclear or contradictory findings from the baseline survey.
 Follow-up Surveys
Follow-up surveys were used to determine impact of communication activities on household members. The first follow-up survey (Wave 2) was held at the end of the intervention period to assess changes from the baseline attributable to intervention activities.
In Wave 2, new communities were sampled in Qena Governorate, in addition to the re-interview of the Minya sample from Wave 1, with random replacement for sample attrition.
Qualitative Research
Qualitative research was conducted among family members, student leaders, village leaders, other local influentials, and service providers (e.g., Raidat Riffiyat and male motivators as well as clinic-based providers) to assess their advocacy of and support for family planning and other health issues, as well as to understand community-level aspects of health competency. CHL research staff and the research contractor developed community-level health indicators before any fieldwork commenced.
The qualitative study included families with members at different life stages in both intervention and control villages. The study followed school age children, youth, parents with children (ages 0-6), young married couples, older people and determine program impact on each of these groups not only according to a participant’s current life stage but also as they move from life stage to another. The qualitative study worked to determine communication program impact on all members of a family as well as the synergistic effect (combined program effect on all members of the family). Particular emphasis was placed on newly married couples.
In the qualitative study, the mother served as the gate-keeper for the health of the family. She addressed her issues regarding her own health priorities as well as those related to other family members who she takes care of or oversees. This part of the qualitative study was done through primarily through focus group discussions followed by select in-depth interviews.
It was found to also be useful to inventory existent groups that cater to life-stage groups, for example youth groups, after school groups, religious study groups, etc. This inventory served two purposes: 1) It allowed us to learn what needs motivate people to come together to form a group during a particular life stage (we learned more about the needs of the life stages depending upon enrollment and attrition in the group). 2) It allowed us access to groups for focused communication interventions.
This qualitative research made use of Primary Sampling Units (PSUs) used in previous Egyptian national surveys; primarily Egypt Demographic and Health Survey (EDHS). All of these resources helped to better interpret the research results in both Wave 1 and 2 from the qualitative and quantitative perspectives.
Secondary Analysis
A secondary analysis of the Egypt Demographic and Health Survey (EDHS) 2003 served to respond to a number of research questions including:
- What is the marriage status, distribution, fertility trends and preferences by residence in Minya. This was classified by age groups of mothers. Emphasis on comparison among generations of mothers/grandmothers helped to also enrich the usability of these data in future planning and impact measurement.
- What is the age distribution among Minya, Qena , Alexandria, Menoufia and Fayoum population especially in the districts where the project exists?
- Detailed statistics related to child morbidity and mortality in relevant governorates. What are the major causes of death for different age groups of children up to 18 years old? What is the prevalence of breastfeeding in project districts? What is the prevalence of malnutrition and anemia among children in these communities?
- What are the trends in maternal health indicators in the project governorates/districts (antenatal care, tetanus immunization and medically assisted deliveries)?
- What are the major causes of death in maternal mortality, its trends by residence and age group?
Monitoring data collection
Community-based and facility-based monitoring data was collected during the program intervention period (including tracking community-based activities, health service statistics, and health-seeking behavior of clients).
Illustrative Mid-program Results
- Data Sources:
- PARC - Reach and Frequency of TV spot exposure
- EDHS, SPA - market segmentation, behavioral and service indicators
- Omnibus - for campaign recall and message comprehension.
- EHCS: Egypt Health Communication Survey 2005, 2006
- Village Health Surveys (VHS)
- pre/post, treatment/control, panel design (CHL focal villages)
- Monitoring System: monitoring of interventions in select villages
- Service Statistics: MOHP, CSI
- IMS Pharmaceutical Index
- Sales Data: Disp. syringes; contraceptives; zinc syrup; condoms
- Qualitative Research: Formative; Pretesting; Case Studies
- Results Graphs and Charts
Back to Egypt
Note about materials: Some of the materials and resources listed on each page are available in their full form, others are represented by image or citation only. For more information and resources, go to www.jhuccp.org
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