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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