Read these instructions carefully: Examination reform and improving health education in Kenya

Examinations strongly influence how students are taught and what they learn, especially in countries like Kenya which use national examinations to select a small proportion of primary school students for further education. This paper reports findings from a demonstration study of the impact of examination question construction on health instruction and learning in a Nairobi primary school. Health test items for the mock Kenya Certificate of Primary Education (KCPE) examination were revised in accordance with cognitive theories of the measurement of achievement emphasizing that the knowledge elicited should be pertinent to structures needed for integrating existing and new knowledge as well as explicitly related to the competent performance of some target behaviour. Teachers of two Standard VIII classes were asked to prepare students to answer KCPE questions or to prepare them for questions the researchers had revised on similar topics. The study indicated that changes in question construction increased lesson preparation and use of texts, encouraged teacher explanations of diseases and fostered understanding of disease processes central to the adoption of practices leading to better health.