Synthetic evaluation of the effect of health promotion: Impact of a UNICEF project in 40 poor western counties of China

SummaryObjectiveTo synthetically evaluate the effects of a health promotion project launched by the Ministry of Health of China and the United Nations Children’s Fund (UNICEF) in 40 poor western counties of China.Study designThe two surveys were cross-sectional studies. Stratified multistage random sampling was used to recruit subjects.MethodsData were collected through two surveys conducted in the 40 ‘UNICEF project counties’ in 1999 and 2000. After categorizing the 27 evaluation indicators into four aspects, a hybrid of the Analytic Hierarchy Process, the Technique for Order Preference by Similarity to Ideal Solution, and linear weighting were used to analyse the changes. The 40 counties were classified into three different levels according to differences in the synthetic indicator derived. Comparing the synthetic evaluation indicators of these two surveys, issues for implementation of the project were identified and discussed.ResultsThe values of the synthetic indicators were significantly higher in 2000 than in 1999 (P = 0.02); this indicated that the projects were effective. Among the 40 counties, 11 counties were at a higher level in 2000, 10 counties were at a lower level, and others were in the middle level. Comparative analysis showed that 36% of village clinics were not licensed to practice medicine, nearly 50% of village clinics had no records of medicine purchases, nearly 20% of village clinics had no pressure cooker for disinfection, and 20% of pregnant women did not receive any prenatal care.ConclusionsThe health promotion projects in the 40 counties were effective. Health management, medical treatment conditions, maternal health and child health care have improved to some extent. However, much remains to be done to improve health care in these 40 poor counties. The findings of this study can help decision makers to improve the implementation of such improvements.