What households credit for changes in their health
Every household answered “Improved” when asked how the health of their family had changed (), and in their own accounts all give at least one influence that made health better. households also name something that made it worse. Four accounts describe the respondent's own health as poor or worse this year: "This year things are getting worst, we often get sicker" (); "I got more sick this year as in comparison to the other years" (); "now I get more sick than usual" (); and “I am always sick” (, second respondent).
- Hygiene and sanitation is the most common influence: households credit it with better health, and 3 more hint at it. In those that only hint, the passage puts hygiene beside health or gives health only as its purpose (, , ). Accounts run from the practice to less sickness: "I no longer get as sick as I used to because I now have good hygienic practices" (); "we do not get sick as much in comparison to last year as I now have good practices in hygiene and health" ().
- Diet and nutrition comes next: households credit it with better health, with 4 more only hinting at it. Many of these accounts concern children and babies, some of whom used to fall ill: "the children would easily get sick this is because they never had nutrition" (); "we did not have a good diet and as a result my household members easily got sick" (). Others link it to infant feeding and to dropping food taboos (, , ).
- Health care comes up less often: households credit treatment or the hospital with better health, and 1 more hint at it. Examples are follow-up on a prescription (), or going to the hospital rather than traditional doctors ().
The chart shows, for each influence, how many households credit it with making health better or worse.
| Better | Worse | |
|---|---|---|
| Hygiene sanitation | ||
| Diet nutrition | ||
| Health care | ||
| Production income | 0 | |
| Climate weather | 0 | |
| General learning | 0 | |
| Other | 0 | |
| Religion beliefs | 0 |
- Production, income or savings, joined directly to health without naming food, appears in households, with 2 more only hinting at it: "More production and this promotes good health" (); "With these changes I can keep my family in good health" ().
- Lessons or help in general, with no practice named, is credited in household, where knowledge from unnamed “NGO's” is said to have made physical health better (). 1 more hints at it ().
The part played by "Organisation 1"
"Organisation 1" is named in interviews and "Organisation 2" in . No interview names both (). In the passages about health, households credit "Organisation 1" by name, and 2 more only hint at it ( and ). All of them are in its own area (). Within that area, the exception is . That household credits the hospital and unnamed “learning” for its health, and names "Organisation 1" only for storing its harvest ().
Its part differs by influence. The chart shows, for each influence, how many households credit it in a passage that names "Organisation 1" and how many in a passage that does not.
- Hygiene and sanitation. households credit "Organisation 1" by name for the hygiene changes behind their better health, and 3 more hint at it. That is households that credit hygiene firmly. The accounts are specific and in the respondents' own words: "With the arrival of Organisation 1 we have good hygienic and health practices in which we use latrines, we wash our hands after using the bathrooms, we use mosquito nets" (); "with the arrival of Organisation 1, we were taught a lot that has been useful in our household" and "I rarely get sick as I did before" (); "Training from Organisation 1 was on improved latrines, washing hands after toilet use, Making Tip Taps (technique) to wash hands and also bathing more often" (). Passages that credit hygiene without naming "Organisation 1" come from households, with 2 more hinting. Most of these households name it in another hygiene passage. In , and the passage names "Organisation 2" or no one (). In its own area, the households that credit hygiene firmly but never name "Organisation 1" for it are and , and only hints at it (, , ).
- Diet and nutrition. households credit "Organisation 1" by name for the dietary changes behind better health, and 2 more hint at it. Diet passages that do not name it come from households, with 6 more hinting; these include 's lack of food, which made health worse. Where it is named, it is often for teaching on infant feeding, shared with the hospital or health centre: "I learnt (from hospital but this was reinforced until we understood when Organisation 1 came with learning on taking care of babies)" (, ). Elsewhere it is credited for meals and dropped taboos (, ). The gap between hygiene and diet would survive one household being read the other way, but it would narrow.
- Health care, production and income. No passage credits "Organisation 1" for health care () or for production or income as a direct route to health (). Several of these households do credit "Organisation 1" for farming elsewhere in the interview (, ). Respondents themselves sometimes join production to better food and then to health: "With the help of Organisation 1 our lives have improved a lot, nowadays through production my family eats a variety of meals" (, ). So this route probably runs partly through "Organisation 1"'s farming work. The health passages credit it there only through diet, so the counts here do not include that indirect credit.
So, compared with the other influences, "Organisation 1"'s activities sit behind the influence households credit most, hygiene and sanitation, and behind part of the second, diet. They are not credited for the health care that some households also rely on, nor for any of the negative influences. § What households credit for changes in their health
The map draws these routes together: on the left, the sources households credit for each influence; on the right, household health. Opposites are combined, so a passage about an influence that made health worse sits on the same arrow as one about the influence making it better, with the flipped ends marked: the arrow from diet to household health holds better food bringing better health and, in , too little food keeping health poor (). The map shows only links that at least two households make, counting both poles together. So the arrow from health care holds both care that helped and care that did not, in households (, ). Every arrow from a source comes from a passage that also says how health changed, so a route such as "Organisation 1" to hygiene to household health is one respondents tell, not one joined up from separate statements.
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holds the documents’ full text
Other organisations and health services
Health services are the main other source named. They are credited for hygiene in households (2 more hinting), for diet in (2 more hinting), and for treatment itself, for better or worse, in (1 more hinting). In "Organisation 1"'s area they are credited for some influence in , , , , and , with and only hinting. That is fewer households than credit "Organisation 1", a difference that would survive one household being read the other way. § The part played by "Organisation 1" Several accounts share the credit between "Organisation 1" and the health services: "thanks to the lectures by the ministry of health and Organisation 1 as well" (); "LECTURES TEACHED WITH Organisation 1 AND THE LOCAL HEALTH CENTER" (); "WITH THE HELP OF THE GOVERNMENT AND Organisation 1" (). So in those households, "Organisation 1"'s part is one of two named sources and cannot be separated from the government's.
In the households naming "Organisation 2", that organisation takes a similar place to the one "Organisation 1" holds elsewhere. It is credited for hygiene in households, with 1 more hinting (). It is credited for diet in , with 1 more hinting. One example: "With the lectures that we had regarding personal hygiene and regarding our yards with the exemplary mother's group from Organisation 2, we now become less sick" (, , ). All three of these households credit the hospital or health centre for treatment ('s for the worse) (, , ). In "Organisation 1"'s area only does, and hints at it. That difference holds in these documents but rests on three households. On diet, health services are credited in and ( hinting) against and ( hinting) elsewhere; with this few documents, that difference is unclear (, ). The same hygiene-and-diet pattern under a different organisation suggests the route to better health reflects this kind of programme, not anything particular to "Organisation 1". § The part played by "Organisation 1" But that comparison rests on households.
Influences that made health worse
Health got worse, or did not improve, in households (, and ). No passage connects these influences to "Organisation 1". Each comes from a single household, except health care, which also hints at. The map shows them with opposites combined: every arrow ends at household health, flipped because health got worse or stayed poor, and the arrows from hygiene, diet and health care are flipped at their start as well, because the passage tells of the lack of that influence rather than its presence:
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- religious rules against the hospital: "Our churches prohibited us from visiting the hospital and as a result five of my children are dead" ();
- not having enough food ();
- climate and weather bringing flu and malaria ();
- medication at the hospital that the respondent felt made things worse (), and, as a hint, hospital pills that brought no change ();
- malaria from sleeping without mosquito nets "as we have not received them in a while" ();
- age ().
These households still answered “Improved” to the closed question, like every other household (). That includes , where the respondent says "This year things are getting worst, we often get sicker" (). In the hinted credit to "Organisation 1" for hygiene () sits beside continuing illness: "We try to change but we still do get sick even though we make use of mosquito nets" ().
Limitations
- The counts are of households in a small sample that was not drawn at random. They say how many of these households said something, not how common it is in the wider population.
- The interviews do not appear to have been blindfolded. "Organisation 1" is named throughout its area's interviews, and each interview ends with an “Important link to” list of organisations. Respondents may have credited it more readily because they knew what the interview was about.
- Credit to "Organisation 1" is counted only where the passage names it. Unnamed “lectures”, “the mothers group” or “a promoter” are not counted, and no list of the programme's activities was available to recognise them. So the counts of credit to "Organisation 1" are a floor.
- Every household rated its health “Improved”, so there is no group whose health did not improve to compare with.
- The interviews for and each hold two respondents' accounts. Each document is counted as one household.