Evidence from health promotion/health education interventions: Relevance of developed world models to a middle income and developing country such as South Africa?

Taylor M, Jinabhai C

Background: The shift to evidence based policy and programmes requires that experiential health promotion case studies be evaluated concerning their relevance for middle income countries. The context of developed versus developing world experiences may influence the applicability of models originating in the developed world. How can South Africa (and other middle income and developing countries) benefit from these experiences ? How appropriate are models which originate in the developed world, to conditions in a country such as South Africa, with its high prevalence of illiteracy, and a population many of whom lack access to modern methods of communication.

Methods: A review of the international literature suggested the relevance of the Precede/Proceed Health Promotion Model for health education interventions for parasite control. A comprehensive framework for planning and implementation, included identification of the contextual and environmental factors and tools for evaluation. A set of psychosocial theories provided a conceptual and scientific underpinning of the educational component of the Precede/Proceed Health Promotion Model.

Results: Evidence from KwaZulu-Natal was used to adapt the Precede/Proceed Model for South Africa, with specific reference to parasite control. A randomised controlled trial indicated that pupils' knowledge increased but that there was little behavioural change. Conclusion: Evaluation of this conceptual model to improve the quality of life suggests the feasibility of adapting the Precede/Proceed model for South African Health Promotion, and the difficulties in developing the intersectoral approach envisaged by the model.