Mass media and health practices evaluations in Honduras and The Gambia : summary report of the major findings

The evaluation, based mainly on longitudinal sample surveys of 750 mothers in Honduras and 1,000 mothers in The Gambia, showed that project strategies succeeded in changing health behaviors. (1) Most Honduran and Gambian mothers had access to radios and to health workers, and most Honduran women lived in literate households; in The Gambia, where household literacy is only 33%, women were taught through the radio and interpersonal channels to "read" pictorial flyers. (2) In Honduras, exposure to radio messages was 80% and to posters 40%. Gambian mothers relied on several information channels: 75% had a mixing flyer, over 50% heard radio messages, 50% knew of the lottery (a contest rewarding correct ORS use), and health workers proved an important source of information. (3) In both SP"s, mothers" knowledge of ORS rose sharply at first and then more gradually; the concept of dehydration proved difficult to understand, but there was some learning of how to treat its symptoms; and there was a general rise in knowledge of breastfeeding and of correct feeding during diarrhea. Overall, learning mirrored the emphasis of the media campaign; when the campaigns focused on a particular issue, learning was high, only to subside when the messages stopped. This indicates a need for sustained attention in health education efforts. (4) In both countries, diarrhea was common, levels of trying ORS were high, actual use increased continually, and most users prepared ORS correctly. Some 36% of recent cases of diarrhea were treated with ORS in Honduras (where use was higher for younger children, those in more rural areas, and the more seriously afflicted) and 62% of cases in The Gambia (where use differed geographically, but not by age). Changes in feeding during diarrhea also occurred, Honduran mothers giving more liquids but with no consistent increase in breastfeeding, Gambian mothers becoming less likely to withhold foods. Over the life of the Honduras SP, more mothers reported breastfeeding young infants as a preventive measure. (5) Declines during both SP"s in childen"s nutritional and growth status were due to worsening economic conditions and in The Gambia to the 1983 drought (Gambian children showed increased wasting). Diarrhea-related mortality among under fives dropped in Honduras from 39.8% for the 2 years prior to the SP to 24.4% in the 2 years after it began. Mortality data were not collected in The Gambia.