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Measuring real-life effects of health interventions

Improving health and reducing mortality requires more than reaching people with presumed beneficial health interventions. Based on the health and demographic surveillance system of the Bandim Health Project in Guinea-Bissau, we monitor the implementation of health interventions and assess their effects.

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Health at
the core of health policy

Health interventions targeting maternal health and child mortality are continuously being rolled out across low-income countries. These interventions are prioritised and promoted based on assumptions about their benefits on health. Consequentially, an increase in uptake or coverage of health services are commonly equated to improved health. 

In Guinea-Bissau, our research team studies the real-life effects of implemented health interventions, aimed at improving child health. Through routine monitoring of maternal and child health, our studies have repeatedly demonstrated that the assumptions may differ from reality. Monitoring coverage of health services is insufficient; the adequate assessment of health interventions is warranted to accurately reflect changes in health. 

Through the Health and Demographic Surveillance System (HDSS) of the Bandim Health Project, our research team has monitored health outcomes for users and non-users of the health system. By monitoring survival and uptake of health interventions in a nationally representative cohort, we can assess to what extent health interventions are implemented as intended - and importantly: whether health interventions impact health and survival as intended.

Selected publications

Cohort profile : Bandim Health Project’s (BHP) rural Health and Demographic Surveillance System (HDSS)—a nationally representative HDSS in Guinea-Bissau

Bandim Health Project monitors health and survival of women and children in a nationally representative rural Health and Demographic Surveillance System since 1990. Data are collected through biannual or more frequent household visits. At all village visits, information on pregnancies, vital status, vaccination status, arm circumference, use of bed nets and other basic information is collected for women and children. More than 25 000 women and 23 000 children below the age of 5 years are under surveillance.
The paper describes the data collection platform and lists some of the findings to date. 
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