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Table 4 Basic Assumptions of a Classic CHC project compared to the intervention as performed in Rusizi District (2014–2015)

From: The value of monitoring data in a process evaluation of hygiene behaviour change in Community Health Clubs to explain findings from a cluster-randomised controlled trial in Rwanda

Basic Assumptions of ‘classic’ (per-protocol) CHC Score cRCT intervention as implemented Score
Training material
 A customized CHC Training Manual 4 CBEHPP Manuals were available and used 4
 Training manual developed/approved by MoH 4 Manual available and used 4
 A tool kit of culturally appropriate visual aids 4 Appropriate visual aids available/well used 4
Sub total 12   12
Trainers
 Sufficient NGO Project staff to support EHOs 4 Not sufficient - only one dedicated PO for district 2
 District leadership to ensure full local support 4 Mayor & District Health Officer removed from post 1
 EHOs to mentor CHC Facilitators 4 Only 6 EHOs to supervise CHC facilitators 2
 Politically enabling environment 4 Minister & Head MoH disabled CBEHPP 0
 The CHC Facilitators are Village Health Workers 4 No public health personnel facilitated CHC 2
 All CHC facilitators get a 5-day training 4 High turnover/30% had to be retrained in situ 3
Sub total 24   10
Transport
 EHOs to have motorbikes 4 Motorbikes provided but after the training in Year 2 1
 Project staff to have dedicated vehicle 4 No vehicle/motorbikes used on dangerous roads 1
 VHWs to have bicycles 4 Supplied but not appropriate as hilly terrain 4
Sub total 12   6
Training
 Size of CHC: at least 70 members 4 32 CHCs (64%) reached > 70 members 3
 Coverage: 80% of village HHs in CHC in Y.1. 4 12 CHCs (24%) reached 80% coverage in Y1 2
 All CHC sessions are participatory 4 Condensed sessions, so less participatory 3
 Only one key message and one homework 4 Many messages and multiple homework 3
 Model Home Competitions held end of training 4 Few competitions were held during intervention 0
 CHC Membership Cards used / signed 4 CHC membership cards were used and signed 4
 Certificates given at Graduation Ceremony 4 Only 50% of CHC held Graduations 2
 Club venues permanent demonstration sites 4 Very few venues permanent or had demonstrations 0
Sub total 32   17
Timing
 Training is conducted during the dry season 4 All training conducted in the rainy season 0
 Six months continuous weekly training 4 Only 4–5 months available for training 2
 24 health sessions meeting once a week 4 Only 4 CHC (8%) held > 20 sessions (mean of 15) 2
 2 h for each session provided 4 At least two hours if more than one topic was done 3
 Only one topic is done per session 4 On average 2 topics done per session 2
Sub Total 20   9
Total possible Score 100 Total Score 54
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