Audit of Haiti family planning outreach project no. 521-0124

Program results audit report covers the period 1/85-12/86 and is based on document review, site visits, and interviews with officials from USAID/H, the Ministry of Health, the Division of Family Hygiene and Nutrition (DHFN), and regional offices. The project has achieved a 38% increase in the number of public and private sector agencies offering FP services and information, and surveys have shown that 90% of Haitian women know about contraceptive methods and 50% have said they would practice FP if methods were made available. (However, evaluations conducted under USAID/H contracts determined that the public sector, which provides the largest number of FP services, has been relatively unsuccessful in doing so.) Implementation has been hampered by GOH decentralization and non-compliance with the project agreement. For example, although the project agreement specified the DHFN as the implementing agency, responsibility for planning and managing FP activities was given to regional agencies, while DHFN was left to provide funding and contraceptives. With no centralized authority to plan and manage, FP service delivery effectiveness was uneven, and DHFN can no longer ensure that project objectives can be met. Implementation was also hindered by delays in GOH allocation of P.L. 480 Title III funds to the project. As a result, at the time of the audit 174 project staff had not received salary checks for over 2 months, eroding morale and serving as a disincentive to continue FP activities. Another obstacle was the misuse of project vehicles - of a sample of 75 trips, only three were taken by FP personnel. Finally, project funds at the regional level were commingled with funds from other sources, in violation of the project agreement. A key recommendation is that USAID/H establish a National Coordinator to report on and evaluate regional accomplishments in comparison with stated regional goals and to release grant and Title III funds based on the accomplishment of these objectives. Other recommendations are that USAID/H: require the GOH to submit the Title III program budget at least 60 days prior to the beginning of the fiscal year; obtain evidence of improved DHFN accountability for the use of project vehicles; and require the regions to establish separate bank accounts for project funds. Mission officials generally agreed with the recommendations.