Agreement for phase II of the project for the strengthening of public health delivery systems in Central and West Africa between the United States of America and the World Health Organization

WHO/AFRO will implement the project"s four components, to: improve health planning and management; train health workers; upgrade disease surveillance and health data systems; and demonstrate low-cost health delivery systems. Twenty African states will participate in the project. (1) The project will improve national and regional health planning and management by training top and mid-level health planners and managers via seminars, short courses and internships at the regional Center for National Planning, Management and Budgeting in Dakar, Senegal. The Center will offer intercountry workshops for ministerial-level personnel unable to attend the Center and will provide follow-up TA to trainees. (2) To upgrade supervisory and local health workers, the project will offer training in primary health care for physicians, nurses, and auxiliary personnel at the Regional Training Centers (RTC"s) in Lome, Togo, and Lagos/Ibaden, Nigeria; trainees will be provided with instructional materials for training of health workers in their home countries. The project will also upgrade curricula, continuing education programs, and TA at the Centres d"Enseignement Superieur en Soins Infirmiers (CESSI"s or Centers for Postbasic Nursing Education) in Dakar, Senegal, and Yaounde, Cameroon; ten CESSI faculty will receive U.S. graduate fellowships. The project may also upgrade nursing education at an anglophone training center in Liberia. (3) To improve regional and national disease surveillance and health/demographic data systems, the project will: conduct immunization training and demonstration programs; introduce courses in disease surveillance, demographic data collection, and disease control (with attention to nutrition) at the RTC"s and CESSI"s; transfer data (including nutrition data) collected in rural areas to subregional surveillance centers and to WHO; and develop a back-up laboratory system. (4) The project will conduct applied research aimed at developing training, service, and research demonstration models for low-cost health care. Amendment of 4/26/83 extends PACD 2 years to 12/85, increases funding, and shifts emphasis in each component. (1) There will be more emphasis in components 1 and 4 on national activities, on training trainers, and producing trainers" guides. Also, component 1 will support institutional networking. (2) Component 2 will take an apprenticeship-trainee approach to training of trainers and will focus on developing the capacity to produce training materials. Nursing education will continue to stress continuing education, with a focus on institutional capabilities to manage regional continuing education programs as well as consultative outreach programs to promote primary health care. (3) In component 3, there will be a major shift from the Expanded Program of Immunization to professional training in epidemiology. (PD-BBH-462)