Restricted accessResearch articleFirst published online 2002-10
Integrating Quantitative and Qualitative Methods to Assess the Impact of Child Survival Programs in Developing Countries: The Case of a Program Evaluation in Ceara,Northeast Brazil
In evaluating public health programs, the tradition has been to design quantitative approaches, relying on epidemiological and statistical techniques to determine if and to what extent a program has an effect on a predetermined targeted population. More recently, however, qualitative methods such as rapid ethnographic assessments and focus groups have been implemented more frequently. This article describes an outcome evaluation of a community health workers program that integrated quantitative and qualitative methods to assess the impact of child survival interventions in reducing infant mortality and inadequate weight gain in children among municipalities in the state of Ceara, Northeast Brazil. By using multiple methods that combine quantitative and qualitative components, researchers can broaden their understanding of complex public health issues and direct use of data for decision making.
Get full access to this article
View all access options for this article.
References
1.
1. Chen LC, Hill AG, Murray CJL, Garenne M: Acritical analysis of the design, results and implications of the mortality and use of health services surveys. Int J Epidemiol22, no. 5(suppl. 1):S73-S80, 1993.
2.
2. Ewbank DC: A strategy for evaluating the mortality impact of child survival programmes in Africa: Combating childhood communicable diseases project. Int J Epidemiol22, no. 5(suppl. 1):S8-S14, 1993.
3.
3. Murray CJL, Chen LC: Monitoring child survival programmes in Africa: The Africa child survival initiative—Introduction. Int J of Epidemiol22, no. 5(suppl. 1):S1-S7, 1993.
4.
4. Bentley ME, Pelto GH, Straus WL, Schuman DA, Adegbola C, de La Pena E, Oni GA, Brown KH, Huffman SL: Rapid ethnographic assessment: Applications in a diarrhea management program. Soc Sci Med27(1):107-116, 1988.
5.
5. Smith GS: Development of rapid epidemiologic assessment methods to evaluate health status and delivery of health services. Int J Epidemiol18, no. 4(suppl. 2):S2-S15, 1989.
6.
6. Van Norren B, Ties Boerma J, Sempebwa EK: Simplifying the evaluation of primary health care programmes. Soc Sci Med28(10):1091-1097, 1989.
7.
7. Scrimshaw SCM, Hurtado E: Rapid Assessment Procedures for Nutrition and Primary Health Care: Anthropological approaches to improving programme effectiveness. Tokyo, the United Nations, 1991.
8.
8. Thompson JC: Program evaluation within a health promotion framework. Can J Public Health83(suppl. 1):S67-S71, 1992.
9.
9. Yach D: The use and value of qualitative methods in health research in developing countries. Soc Sci Med35(4):603-612, 1992.
10.
10. Anker M, Guidotti RJ, Orzeszyna S, Sapirie SA, Thuriax MC: Rapid evaluation methods (REM) of health services performance: Methodological observations. Bull World Health Organ71(1):15-21, 1993.
11.
11. De Vries H, Weijts W, Dijkstra M, Kok G: The utilization of qualitative and quantitative data for health education program planning, implementation, and evaluation: Aspiral approach. Health Educ Q19(1):101-115, 1992.
12.
12. Hugentobler MK, Israel BA, Schurman SJ: An action research approach to workplace health: Integrating methods. Health Educ Q19(1):55-76, 1992.
13.
13. Buchanan DR: An uneasy alliance: Combining qualitative and quantitative research methods. Health Educ Q19(1):117-135, 1992.
14.
14. Helitzer-Allen DL, Kendall C: Explaining differences between qualitative and quantitative data: A study of chemoprophylaxis during pregnancy. Health Educ Q19(1):41-54, 1992.
15.
15. Pope C, Mays N: Reaching the parts that other methods cannot reach: An introduction to qualitative methods in health and health services research. Br Med J311:42-45, 1995.
16.
16. Barbour RS: The case for combining qualitative and quantitative approaches in health services research. J Health Services Research & Policy4(1):39-43, 1999.
17.
17. Kroeger A: Health interviews in developing countries: Areviewof the methods and results. Int J Epidemiol12(4):465-483, 1983.
18.
18. Stange KC, Zyzanzki SJ: Integrating qualitative and quantitative research methods. Fam Med21:448-451, 1989.
19.
19. Minayo MC, D’Elia JC, Svitone E: Programa de Agentes de Saude do Ceara: Estudo de Caso. Fortaleza, Brazil, UNICEF, 1990.
20.
20. Secretaria Estadual da Saude. Sistema de Informacao do Programa Agentes Comunitarios de Saude (P.A.C.S.): Instrutivo para o preenchimento de Fichas e Documentos. Fortaleza, Brazil, Outubro, 1992.
21.
21. Terra de Souza AC, Svitonne E, Peterson KE, Gardner J, do Amaral MIV, Ascherio A: Variations in infant mortality rates among municipalities in the state of Ceara, Northeast Brazil: An ecological analysis. Int J Epidemiol28:267-275, 1999.
22.
22. Terra de Souza AC, Svitonne E, Peterson KE, Gardner J, do Amaral MIV: Underlying and proximate determinants of diarrhea-specific infant mortality rates among municipalities in the state of Ceara, Northeast Brazil: An ecological study. J Biosoc Sci33:227-244, 2001.
23.
23. Terra de Souza AC, Peterson KE, Cuffino E, Gardner J, Craveiro MVA, Ascherio A: Risk factors for inadequate weight gain in children 0-23 months among municipalities in the state of Ceara, Northeast Brazil: The role of health services and socio-economic variables. Bull World Health Organ77(11):895-905, 1999.
24.
24. Terra de Souza AC, Peterson KE, Gardner J, Andrade MF, Ascherio A: The circumstances of post-neonatal deaths in Ceara, Northeast Brazil: Mothers’health care-seeking behaviors during their infants’ fatal illnesses. Soc Sci Med51:1675-1693, 2000.
25.
25. Bauman LJ, Adair Greenberg E: The use of ethnographic interviewing to inform questionnaire construction. Health Educ Q19(1):9-23, 1992.
26.
26. Sells SP, Smith TE, Sprenkle DH: Integrating qualitative and quantitative methods: A research model. Fam Process34:199-218, 1995.
