ASHA [American Schools and Hospitals Abroad] program assessment : program criteria for American ideas and practices

The leading recipients have been institutions in Lebanon ($232 million), Israel ($112 million), Egypt ($40 million), and Turkey ($38 million). The newest recipients, having received their first grants in 1992, are four institutions in Armenia, Bulgaria, Bolivia, and Sierra Leone. During the first two decades of the program, decisions on ASHA grants were made largely on the basis of U.S. geopolitical concerns as interpreted by key members of Congress. In recent years, however, with the winding down of the cold war, policymakers have expressed the need for ASHA awards to be made more on the basis of objective criteria and less on political grounds. This has led to the exploration of several issues which had been dormant. The intent of this paper is to reexamine ASHA"s central thrust -- the attempt to export "American Ideas and Practices" (AMIP). Part One of the paper contains the assessment team"s analysis of the content, legitimacy, and feasibility of the ASHA effort, as well as suggestions for improving program criteria, assessing progress, and avoiding pitfalls. Part Two provides reports on the team"s visits to 29 ASHA-supported institutions in Israel and the West Bank, Turkey, Greece, Pakistan, India, Thailand, and the Philippines. The team came to the following conclusions: (1) the program has been quite effective over the years in exposing a large number of students, professional staff, and hospital patients to AMIP; (2) agreement is needed within A.I.D. and with ASHA sponsors on what constitutes AMIP; (3) a more structured approach is needed for assessing ASHA impact to determine the most effective techniques for inculcating AMIP; (4) considerably more mileage can be obtained from the existing level of ASHA resources by graduating some of the older grantees and replacing them with institutions with promise in the developing world; (5) the grant award process can be strengthened by the adoption of more objective criteria; and (6) there is a danger that some of the older, more established schools that ASHA has assisted over the years may be instilling or reinforcing a spirit of undemocratic elitism. (Author abstract, modified)