A 2 X 2 factorial design with lecture versus participation as 1 variable and teaching team as the other was used to assess the health training of 272 Peace Corps volunteers. Before-after training tests were given for knowledge, attitudes, and beliefs about specific illnesses, and intention to follow recommended personal and community health behaviors. Results indicate that, with the specific task of health training, participation is not more effective than lecture, although teachers or teaching teams do differ in effectiveness. Further, if students do have a preference, it is for the lecture method.
PLANNING for health in developing areas of the world is agonizing and f rustrating. Conf ronting the planners are multiple problems directly concerned with physical health, magnified by socioeconomic and cultural factors that are almost overwhelming. A severe shortage of personnel and money complicates the already confusing picture, thereby preventing use of more than a small fraction of the scientific knowledge available for health and medical care. Furthermore, conditions in these coun¬ tries seem to result in the development of pro¬ grams that appear contrary to goals. Because of the immensity of the problems, I propose to examine three paradoxical situations. 1. The greater the proportion of the health budget spent on curative services, the longer the delay in permanent health improvement. 2. The greater the attraction of the mirage of Western health and medical care systems, the more difficult will be the development of an appropriate health and medical care system. 3. The smaller the difference in educational level between health auxiliary workers and the general population, the more effective those workers will be. At first glance, one or all of these statements seem contrary to usual practice and attack suppositions on which much of health work is founded. The first would downgrade the im¬ portance of curative services. The second desacralizes the "sacred cow" of Western medical care and health systems. The third seems con-Dr. Rice is a lecturer in international health, public health, and preventive medicine,
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