Guinea worm control: testing the efficacy of health education in primary care.

Health education has been advocated as a major foundation for primary health care. However, the value of this approach is yet to be fully proven. An experimental PHC programme in ten Nigerian farm hamlets using methods such as community organization, participatory training and village meetings, put health education to the test. Significant short term improvements in community health knowledge resulted after training of a village health worker from each hamlet. Positive intermediate results in water sanitation behaviours were later observed. Three years after initial intervention, long term health outcomes included the reduction in prevalence of guinea worm, a locally endemic water borne disease. The programme also encountered certain organizational and technological issues. For example, integration with existing health care systems and local well construction capabilities surfaced as problems. Consequently efforts are currently underway to expand research into these areas.