PROBLEMS REALTII
CHAPTER 3: METHOD
3.7 Instruments
3.71 Input Data Instruments
A questionnaire was developed and utilised to collect input data. It was mailed out to SHNs to fill in and return to the researcher. It recorded data on SHS team base; the number of teams in 1995; number of schools allocated;
number of rural, urban and peri-urban schools; the numbers of schools visited; and those schools not visited. It also required numbers of children
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seen on HI, pupils found to have health defects and those referred for further treatment. This data was utilised to calculate coverage. (Annexure C)
For costing of HI, a questionnaire was developed and sent out to SHS teams to fill in and return to sender. The questionnaire required the SHN to review records of expenditure for the 1997 financial year and complete the
questionnaire to provide expenditure on personnel, equipment, vehicles, stationery, medical supplies, telephones, electricity, water and rent. Head office personnel were requested to provide data on salaries. (Annexure D)
The unit SHS consultation cost of three teams, one from NP A, NH and KZ previous health departments was estimated. The finance section at head office was requested to provide the school health budget. Head Office was not able to supply the information up to the time of writing the report. The official who was approached promised to provide the information on the last SHS allocation before the service ceased to be a budget objective and was integrated with PHC.
The school health service's regional coordinator who controlled school health services in region B in 1997 provided the estimate of the budget. She was not able to supply the specific budget because, according to her, she was never given the specific budget; she worked on assumptions based on her estimates.
Due to the fact that SHS teams did not know the allocated budgets, costing was based on the records of expenditure.
Teams were requested to provide a list of names of all team members and their salary numbers. The Personnel department was requested to supply copies of pay-slips for 1997. Pay slips reflected such information as annual salary notch, allowances and subsidies. Teams were asked to indicate if there was any time during the year when they were not doing SHS work. All three teams had done SHS work for the whole year. The cost of supervision was not included.
Teams were requested to supply the total distance traveled in 1997.
Kilometers traveled were multiplied by the transport maintenance flat rate of 69c per kilometer. The estimated cost of the vehicle used was added to the estimated running and maintenance cost. One team knew the actual cost of transport for the year of review.
This section included equipment, stationery, rent, telephone, maintenance, water, medications and expendables. Calculations were based on records such as requisition books, forms and expenditure statements.
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3.7.2 Process Data
A checklist was developed and used for the process of HI. It had five sections. Section A had twelve points. This section covered the demographic characteristics as well as the target and output statistics. Section B looked at the follow-up visits. Section C dealt with the process of ID, including parent interviews, meetings and home visits. Section D covered the referral services. Section E looked at the categories of staff involved in ID. (Annexure B)
3.7.3 Output And Outcome Data
The interview guide which was developed for use in the study was pre-tested in region D using a group of pupils that had the same characteristics as the sample, but who were not part of the study - it was found to be consistent in obtaining expected responses. A pilot study to test the questionnaire was conducted at a school that was not going to be part of the sample. During the study consistency was well demonstrated in the responses that were given by participants. The research assistant who participated in field data collection was trained in interviewing techniques.
The interview guide had four sections and only three were used. Section A measured demographic characteristics of respondents. Section B dealt with referral for health care. Pupils were asked if they were given a referral letter and whether they were told what to do with letter. If pupils went for
treatment they were asked to say what happened at the referral point. Those pupils who did not go for treatment were asked to say why they did not go.
Section C was a parents' interview guide. It looked at the parents'
demographic characteristics; whether or not parents received the referral letter; and if yes what was done about it. The aim of this section was to verify what the children said and to see whether HI had any influence on the
parents' decision to treat or not to treat a child. (Annexure A)
There was no instrument; instead a set of the following questions were used:
Name of school Date of the last HI
Number of children seen at the last HI
Children found to have health defects at the last HI Total enrolment