Date of Award


Degree Type


Degree Name

Doctor of Philosophy


This research has attempted to evaluate the function of village health workers in health promotion, prevention, and curative services provided for rural children under five years of age.;A survey was conducted to determine maternal knowledge of childhood infectious diseases and childhood immunization, and to compare the immunization status of children aged 6-23 months in villages with and without a village health worker. A cohort study was carried out to compare the medical care provided for diarrhea, fever, and cough to children aged 6-59 months in villages with and without a village health worker.;It was expected that the DPT immunization coverage (2-doses) of children in villages with a village health worker would be 10 percentage points higher than that of children in villages without a village health worker. It was also expected that the medical care provided by the village health worker would not be substantially inferior to that provided by health centre personnel (i.e. the frequency of poor outcome of illness would not be more than 10 percentage points higher among the former).;A multivariate analysis showed that DPT immunization coverage in village with and without a village health worker was not statistically significantly different. Coverage of BCG immunization was better in villages with village health workers, but coverage of polio immunization was better in villages without village health worker.;In the univariate analysis, the health care system with village health workers showed a better outcome for diarrhea, fever, and cough than the health care system without village health workers. After adjustment for potential confounding variables the differences were not significant.;The results suggest that the village health worker provide adequate care for common childhood illnesses but do not enhance immunization coverage of the child population. Definitive studies need to be carried out to determine the best means of training of the village health worker to provide promotion and prevention services as well as therapeutic services for common illnesses.



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