AID cooperative agreement no. 519-0367-A-00-0188-00, amendment no. 1 with the Medical Service Corporation International for the implementation of a maternal health/child survival project

The project will: (1) support MH/CS service delivery by PVO"s; (2) promote PVO institutional development; and (3) support related coordination and research. MSCI will support delivery by a network of 35-50 Salvadoran PVO"s of a wide range of preventive and, to a lesser extent, curative MH/CS services. (1) Community health education for both men and women will focus on areas such as contraception, pregnancy, birth, diet, hygiene, infectious disease, and growth monitoring. (2) Traditional birth attendants will receive training to improve their practices, enable them to recognize risks, and use referral where appropriate. (3) Equipment and TA will be provided for the construction of potable water and sanitation systems and for related community education. (4) MH/CS-related medical/technical interventions will include clinic services, community education groups, health promoter training, vaccinations, oral rehydration therapy, vitamin A distribution, birth spacing methods, prenatal and neonatal care, treatment of infectious diseases (especially diarrhea and respiratory infections), and referral of pregnancy- related complications. Efforts will be made to ensure community participation in the design and implementation of these services. MSCI will work with the PVO"s to ensure cost recovery through community participation in building water systems and the charging of fees for medical services. MSCI will strengthen participating PVO"s institutionally through training in such areas as project preparation, financial management, cost recovery, supply management, monitoring and evaluation, and training of community health personnel. More individualized TA will be provided in community participation, water and sanitation, and financial management. Training will be tailored to PVO needs and will include a variety of methods, including use of long- and short-term TA, national conferences and short seminars, and, possibly, a visit to a third country for community health specialists and trainers. MSCI will also serve as a catalyst for establishing cooperative links with U.S. PVO"s. Finally, MSCI will foster cooperation and coordination between PVO"s and host government agencies. Working through the Ministry of Health"s (MOH) Office of International Cooperation (OIC), MSCI will promote MOH coordination with PVO"s in areas such as the sharing of training materials, joint training of personnel, PVO assistance with MOH services, and the possible coordination of pharmaceutical purchases. OIC personnel will receive training in information collection and dissemination and its director will visit countries having a successful OIC. The Inter-Sectoral Committee for Child Survival will receive TA to help PVO"s identify important areas for policy dialogue related to health services. MSCI will also provide training to other PVO coordinating committees and conduct a limited amount of health operations research. Approximately 350,000 people are expected to benefit from the project.