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Evaluation of an Interactive Electronic Health Education Tool in Rural Afghanistan

Published online by Cambridge University Press:  17 February 2017

Glen Kim ,
Suzanne Griffin ,
Hedeyat Nadem ,
Jawad Aria  and
Lynn Lawry
Glen Kim*
Affiliation:
Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA Brigham and Women's HospitalAcademic Hospitalist Service, Boston, Massachusetts, USA
Suzanne Griffin
Affiliation:
International Medical Corps, Washington, DC, USA
Hedeyat Nadem
Affiliation:
International Medical Corps, Washington, DC, USA
Jawad Aria
Affiliation:
International Medical Corps, Washington, DC, USA
Lynn Lawry
Affiliation:
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA International Medical Corps, Washington, DC, USA Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA Center for Disaster and Humanitarian Assistance Medicine, The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, Maryland, USA
*
Glen Kim, Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, 15 Francis Street, PBB-B-428, Boston, MA 02115 USA, E-mail: [email protected]
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Abstract

Introduction: Low education levels may limit community-based health worker (CHW) efforts in rural Afghanistan. In 2004, LeapFrog Enterprises and the United States Department of Health and Human Services developed the Afghan Family Health Book (AFHB), an interactive, electronic picture book, to communicate public health messages in rural Afghanistan. Changes in health knowledge among households exposed to the AFHB vs. CHWs were compared.

Methods: From January–June 2005, baseline and follow-up panel surveys were administered in Pashto-speaking Laghman and Dari-speaking Kabul provinces. Within each province, an AFHB and a CHW district were randomly sampled using a stratified, 2-staged cluster sample design (total 98 clusters and 3,372 households). Surveys tested knowledge of 17 health domains at baseline and on follow-up at three months. For each domain, multivariate logistic regression was used to assess the effect of the AFHB on follow-up pass rates, controlling for demographics and differences in baseline knowledge.

Results: Both AFHB and CHW resulted in statistically significant changes in pass rates on follow-up, although there were greater gains among AFHB users for five domains among Pashto-speakers (micronutrients, malaria, sexually transmitted diseases, postpartum care, and breast-feeding) and seven domains among Dari-speakers (diet, malaria, mental health, birth-spacing, and prenatal/neonatal/postpartum care). Community-based health workers effected greater knowledge gains only for the Dari breast-feeding module. Participants favored CHW over the AFHB, which they found poorly translated and difficult to use.

Conclusions: The AFHB has potential to improve public health knowledge among rural Afghans. Future efforts may benefit from involvement of local health agencies and the integration of interactive technology with traditional CHW approaches.

Keywords

Afghanistaneducationelectronic education
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 3 , June 2008 , pp. 218 - 226
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. United Nations Children's Fund (UNICEF): Afghanistan-Statistics. Available at http://www.unicef.org/infobycountry/afghanistan_afghanistan_statistics.html. Accessed 06 December 2005.Google Scholar
2. UNICEF: Maternal Mortality Rates. Available at http://www.irinnews.org/report.asp?ReportID=30819&SelectRegion=Central_Asia&SelectCountry=AFGHANISTAN. Accessed 06 December 2005.Google Scholar
3. US Agency for International Development (USAID): Afghanistan: Empowering Afghan women and expanding community-based health care. Available at http://www.usaid.gov/locations/asia_near_east/afghanistan. Accessed 06 December 2005.Google Scholar
4. USAID: Afghanistan: Enhancing education. Available at http://www.usaid.gov/locations/asia_near_east/afghanistan/education.html. Accessed 14 March 2006.Google Scholar
5. UNICEF: Afghanistan-Background: Available at http://www.unicef.org/infobycountry/afghanistan_7982.html. Accessed 14 March 2006.Google Scholar
6. Thomas, R, Cahill, J, Santilli, L: Using an interactive computer game to increase skill and self-efficacy regarding safer sex negotiation: Field test results. Health Educ Bebav 1997;24:71–86.Google Scholar
7. Stout, PA, Villegas, J, Kim, H. Enhancing learning through use of interactive tools on health-related websites. Health Educ Res 2001;16:721–733.Google ScholarPubMed
8. Robinson, TN, Patrick, K, Eng, TR, Gustafson, D, for the Science Panel on Interactive Communication and Health: An evidence-based approach to interactive health communication: A challenge to medicine in the information age. JAMA 1998;280:1264–1269.CrossRefGoogle ScholarPubMed
9. Leapfrog partners with US Department of Health and Human Services to bring health information program to women in Afghanistan. Available at http://www.leapfrog.com. Accessed 20 July 2006.Google Scholar
10. Kutner, M, Greenberg, E, Jin, Y, et al. : The health literacy of America's adults: results from the 2003 National Assessment of Adult Literacy. Available at http://nces.ed.gov/pubs2006/2006483.pdf. Accessed 01 February 2007.Google Scholar
11. US Centers for Disease Control and Prevention: Nationwide measles vaccination campaign, Afghanistan, 2002. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a3.htm. Accessed 04 December 2005.Google Scholar
12. IRIN-Asia: Afghanistan, polio vaccination campaign 2005. Available at http://iys.cidi.org/humanitarian/hsr/centralasia/ixl106.html. Accessed 04 December 2005.Google Scholar
13. Afghanistan, tetanus vaccination campaign, 2003. Available at http://www.europaworld.org/week127/afghanistan2503.htm. Accessed 04 December 2005.Google Scholar
14. WHO: Advancing Safe Motherhood through Human Rights. Available at http://www.who.int/reproductive-health/publications/RHR_01_5_advancing_safe_motherhood/. Accessed 05 February 2006.Google Scholar
15. Amowitz, LL, Reis, C, Iacopino, V: Maternal mortality in Herat Province, Afghanistan, in 2002: An indicator of women's human rights. JAMA 2002;288:1284–1291.CrossRefGoogle ScholarPubMed
16. Health Net International: Available at http://www.who.int/disasters/repo/7410.pdf. Accessed 14 December 2005.Google Scholar
17. RBM Complex Emergency Malaria Data Base. Available at http://www.liv.ac.uk/lstm/malaria/afghanistan.pdf. Accessed 14 December 2005.Google Scholar
18. Hill, Z: Reducing attrition in panel studies in developing countries. Int J Epidemiol 2004;33:493–498.Google Scholar