Health education interventions in developing countries : a methodological review of published articles

Some 67 journal articles that described and evaluated health education programmes in developing countries were read by two independent reviewers who examined the methodology used in the studies. Of the articles 47 per cent provided a sufficiently detailed description of the educational intervention to allow replication and 40 per cent described the educational level of the intended audience. Only 21 per cent were controlled studies employing sample sizes greater than 60 individuals or two clusters, although six studies used ramdomized or quasi-randomized designs. Of the studies 33 per cent looked at changes in health status while another 33 per cent used observable changes in health behaviour as an endpoint. The authors argue that it is important to improve the methodological quality of health education research, and they suggest that this can be done by using controlled, preferably ramdomized, designs, ensuring adequate sample sizes, examining only objective changes in behaviour or, still better, changes in morbidity or mortality. It is also stressed that research reports should describe in detail the educational intervention employed and the target audience.