Use of RE-AIM Model to Assess Factors that Influence Outputs for Health Promotion Interventions in Kabale District.

Abstract

TWESIGYE NESTERIO (2011-M121-10019) Use of RE-AIM Model to Assess Factors that Influence Outputs for Health Promotion Interventions in Kabale District. The study about the use of the RE-AIM model to assess factors that influence outputs for health promotion interventions was carried out in Kabale district. The study was descriptive comparative and cross-sectional in nature taking largely a qualitative approach with a few quantitative aspects. Health promotion interventions were compared basing on the dimensions of the RE-AIM model which include reach, effectiveness, adoption, implementation and maintenance. The RE-AIM frame work provided the basis for assessing factors which influence the outputs for health promotion interventions being implemented in Kabale district. Two health promotion interventions were considered in this study and these included the improved rural water supply which is being implemented by Kigezi Diocese Water and Sanitation Project (KDWSP) and the HIV/AIDS prevention intervention that is being implemented by Community-Based HIV/AIDS Project (CBHAP). The goal of this study was to establish information about factors that influence the outputs for health promotion interventions being implemented in Kabale district so as to suggest appropriate strategies for improving people’s health. The specific objectives included; to find out the reach of health promotion interventions to their target beneficiaries, assess their perceived effectiveness, determine their adoption, and assess their implementation and maintenance in Kabale district. The effectiveness of health promotion interventions was assessed without a control or baseline data using community capacity building as its proxy measure. Quality assurance principles and factors influencing the likelihood for the sustainability of an intervention were used to assess their implementation and maintenance respectively. Data were collected during the period from February 1st - 28th 2013 and then April 5th - May 4th 2013. The data were collected by holding in-depth interviews, focus group discussions and reviewing records of the benefiting groups. Various data collection tools were used including, the interview guide, quality checklist, sustainability checklist, community capacity index tool and records review checklist. The data were obtained from people who were presumed to be having a wealth of information about the two health promotion interventions. The collected data were analysed by drawing out key themes and the findings presented using tables and in a narrative form. 15 The study findings indicated that the factors which influence outputs for health promotion interventions being implemented in Kabale district are related to their reach, perceived effectiveness, adoption, implementation and maintenance. Such factors include identification of target population, gender disparities, poverty levels in the community, nature of land, network/partnerships development, knowledge transfer, problem solving and mobilisation of resources. Others include adoption by relevant settings and partner agencies, dissemination of results, strategic planning, management of the intervention, education and training for managers and staff, collaborating with multiple stakeholders, use of bottom-up approach, likelihood for sustainability, investing in trainings for the local people, prospects for future funding and integration of activities into those of the host agency. The study finally recommended that the Ministry of Health (MOH) should collaborate with other relevant ministries such as Ministry of Water and Environment (MOWE) and Ministry of Local Government (MOLG) to lobby and mobilise for some resources so as to support successfully implemented health promotion interventions when the donors have reduced or withdrawn their support. Key Words: RE-AIM Model, Assess, Factors, Influence, Outputs, Health, Promotion, Interventions, Kabale District.