Monitoring of community health status: experience from a case study in Tanzania.

The experience from the first four years of a longitudinal study on interrelations between nutrition, parasitic infections, immunity and environmental factors in a rural community, Kikwawila village (southeastern Tanzania) is reviewed. Two elements supported the implementation of the project. Firstly, the multidisciplinary approach with surveys across a range of biomedical and agricultural science disciplines has enabled the elucidation of part of the complexity of the mutually reinforcing, changing interrelations which can affect child health. Secondly, the primary health care component based on village health workers which paralleled the research project has facilitated the longitudinal character of the study and has triggered some community participation. The studies also indicated that the indigenous perceptions of disease, signs and symptoms may be used as an integrative tool to monitor health care programmes. Already during an initial stage of a project, the indigenous health perspectives could become indicators for community participation and could help to determine the strategy of applied research and control measures within primary health care.