Community health assessment index content and face validation studies

The objective of the study was to evaluate content and face validity of Community Health Assessment Index (CHAI). Two independent groups of experts convened in Dar-es-salaam and Eldoret after having had a chance to study CHAI for two or more weeks in order for them to make written evaluations on the index. Twelve and 11 experts representing a broad range of interest in community health in the African context convened in Dar-es-salaam and Eldoret respectively. Most of these were nominated by their respective institutions, namely, ministries of health, academic and research institutions and non-governmental and multilateral organisations. The findings of the two groups of experts were very similar. The consensus was that CHAI has face and content validity. However, both groups suggested that (i) total adult mortality instead of male adult mortality be used; and (ii) that a 5 km rather than 10 km radius be used to define accessibility to health care. Regarding to questionnaire the consensus was that (a) the questions were both clear and culturally appropriate; (b) apart from the part which concerns a description of health services policy and community participation, the questionnaire could be administered by literate primary health care workers after appropriate training and translation; and (c) in addition to generating CHAI scores, the data gathered with this instrument could be used for planning and evaluation at the local community level. Overall the questionnaire was judged as "good" by 19 while the remaining 4 judged it as being "very good". Several suggestions in wording were made. Also a few additional questions were suggested. This evaluation provides justifications for further studies to assess the remaining measurement properties of this index.