HEALTHY HOMES PROJECT: Results

The results of the final evaluation show that the program was a great success, despite the many challenges. 

Before launching the behavior communication intervention, the knowledge and behaviors of mothers in the five categories were measured using the Baseline Survey. After participating in the project, the knowledge and behaviors of participants were measured for a second time, using the Final Survey (an adaptation of the Baseline Survey).  The results of the surveys were compared to determine the degree to which participating mothers had adopted knowledge and attitudes that serve as the foundation for a healthy home.

Results of the final evaluation showed improvements among participants on 18 of 22 behavioral indicators, including the following notable results:

Indicator	Before intervention (baseline)	After intervention (final)
Mothers demonstrate the correct manner to wash hands	48%	78%
Mothers drink safe water	88%	100%
Mothers maintain water receptacles clean and covered	48%	89%
Place to wash hands exists in the home near the kitchen and/or the bathroom	24%	97%
Mothers know the correct ingredients (and quantity) to prepare ORS	24%	75%
Mothers mentioned at least 2 new practices adopted in the previous few months to maintain a healthy home	n/a	66%
Mothers exclusively breastfed child until at least 6 months of age	92%	100%
Mothers name foods high in protein	67%	84%
Mothers recognize the symptoms of pneumonia	53%	81%
Mothers use improved cook stove every day	n/a	68%
Mothers engage children in activities to stimulate early childhood development	44%	80%
Mothers mention at least 3 improvements in the physical or mental development of their child	N/A	97%

Most importantly, 17% of participating children who were underweight or under height for their age prior to launching the program had recuperated weight and/or height to fall within the normal range by the end of the program.

The results are impressive, but we must consider the confounding effects that influenced these results due to the overlap of some mothers who were also enrolled in concurrent projects mandated by the regional government.  All 30 families had also participated in the JUNTOS program and five families had also participated in the Familia Feliz program.

The JUNTOS program coordinated with the health promoters to organize compulsory lectures on various topics related to the health of the family and maintenance of the household.  Some topics presented to the participants of the JUNTOS program overlapped with the topics presented in the Healthy Homes program.  While this overlap caused confusion among participants, and burdened them to comply with similar requirements of two programs, it may have provided the benefit of reinforcing the same message across programs.  The repetition of key messages and additional opportunities to practice new behaviors may have improved recall and sustainability of behavior changes.

The Familias Feliz program was focused entirely on showing mothers how to engage their children in activities that stimulate early childhood development and its narrow focus allowed them to delve deeper into techniques than we were able to do with the Healthy Homes program.  The five families enrolled in the Familias Feliz program (that were also enrolled in the Healthy Homes program) received much more in-depth guidance and training than the other participating families and likely benefitted from the additional intervention.

The only way to separate the effect of the additional interventions by other programs on the results of the Healthy Homes program was to compare the families in the Healthy Homes program who had received the intervention with families in the Healthy Homes program who had not received the intervention, but were enrolled in the JUNTOS and/or Familias Feliz programs.

Fortunately, we had three families that had received a cook stove but had not participated in the educational sessions nor the house visits, which meant that these families received the incentive to change behavior but did not have opportunities to gain knowledge or practice new behaviors through the Healthy Homes program.  If new knowledge and behaviors were adopted, it would have resulted from participation in the JUNTOS or Familias Feliz programs.

Because these families did not receive the intervention they can serve as a control group to participants in the Healthy Homes program. By comparing the knowledge and behavior of the group that received no intervention against the group receiving the intervention, we can determine with certainty that improvements in knowledge and behavior reflected by the Healthy Homes participants that were not reflected by the control group were the result of the Healthy Homes intervention.

The comparison showed that the eight indicators listed below were the result solely of the Healthy Homes intervention:

• Mothers hold water containers clean and covered

• Households that have a hand washing station

• Mother named at least two practices to prevent diarrhea

• Mother mentioned at least two new practices adopted in recent months to maintain a healthy home

• Mother named at least two signs or symptoms of a parasitic infection

• Mother named high-protein foods

• Mother engaged child in activities to stimulate mental and physical development

• Mother named three changes in the development noticed in your child

The remaining 14 indicators were most likely the result of the combination of effects from participation in the Healthy Homes, JUNTOS and Familias Feliz programs.

The health center staff has indicated a high level of interest in replicating the program, which will allow more families to gain the benefits of participating and hopefully lead to a greater community impact.

Please click here to read about the program benefiting adolescents in the same community.