Audit of Rwanda maternal child health/family planning project, project no. 696-0113

Audit report covers the period 9/81-7/85 and is based on site visits, document review, and interviews with GOR and A.I.D. officials. Most activities are behind schedule. Several factors have contributed to the delays: (1) the National Population Office (ONAPO) has been unable to hire and retain professional staff and has had difficulties in obtaining cooperation from the Ministry of Public Health and Social Affairs; (2) there have been preventable delays in constructing facilities; (3) educationally qualified long-term participants have not been identified in a timely manner; and (4) A.I.D. has failed to provide sufficient long-term TA. On the whole, it seems that the project"s goals and objectives are too ambitious for a country with critical shortages of skilled personnel and facilities. The project has made some progress, however. A patient recordkeeping system has been developed, some short-term training provided, and a combined health and nutrition center renovated. A.I.D. resources are being used as planned, in compliance with applicable laws, Agency regulations, and the project agreement, and in an economical and effective manner. The project is consistent with the GOR"s strategy of providing primary health care to all by the year 2000. It is concluded that project goals should be re-evaluated and reduced to achievable levels. Further, the Office of the A.I.D. Representative/Rwanda should: (1) obtain a firm understanding with the GOR relative to securing permanent positions for ONAPO employees; (2) enter into dialogue with the GOR regarding interdepartmental cooperation; (3) step up monitoring of construction activities; and (4) take agressive steps to improve the participant training program. (Author abstract, modified)