AID integrated low cost health projects. Volume II : analysis

has been a pioneer in advocating low-cost, integrated primary health care systems to alleviate the dire health conditions of the rural poor in developing countries. This contractor"s report, the second of two volumes, analyzes the nutrition interventions in 39 A.I.D. primary health care projects in Africa, Asia, Latin America, and the Near East. The first volume provided a general review of the individual projects. Introductory sections provide an overview of A.I.D."s primary health care projects in terms of the health background of AID-assisted countries, target populations, project funding, health care personnel (especially village health care workers), and degree of integration of health, nutrition, and family planning services. In regard to nutrition interventions, it was found that only 18 of the 39 projects utilize, in varying degrees, the minimum nutrition activities suggested by the World Health Organization (WHO): nutrition surveillance and education, control of infectious diseases, nutritional supplements, and nutrition recuperation. A number of the 18 projects lack even these minimum interventions. At the same time, A.I.D. projects do involve a broader range of nutrition interventions than those listed by WHO. These include breast-feeding, use of mass media to promote nutrition education, development of garden projects, and improving sanitation. Several areas in which the nutrition component of A.I.D. primary health care projects can be improved are specified: weight charts, supplemental food, anemia, breast-feeding, weaning, immunization, disease control, and family planning. General and specific recommendations are made to implement these improvements by tapping the knowledge, motivation, and organizational/communication skills of implementing personnel. Results of two other studies of small, privately-funded, low-cost primary health and nutrition projects are included for comparison. Also included are tables illustrating the report"s findings.