BASIC FAMILY HEALTH SERVICES

The project will finance the establishment and initial operation of replicable, pilot programs in three rural zones (Kisantu, Vanga, Bolobo) and in two urban zones (Kinshasa, Kisangani). These will correspond to existing GOZ administrative zones and will encompass 50-250,000 people. Each zone will be served by a hospital with three doctors, although urban zones may share hospitals. A Managing Council comprised of these doctors, the Managing Administrator, and the Commissaire du Zone will meet monthly to supervise zone administration and training programs. At the subzone level, Health Centers with two nurses, two nurse"s aide/midwives, and up to three community health workers will serve 30-40,000 people. Localities of 5,000 people will have access to a Community Welfare Center staffed by a nurse"s aide, two or three assistants, and one or two family planning outreach personnel. At the village level, a male and female health worker will be available to instruct the 500 inhabitants in community health, sanitation, and family planning. A patient referral system will operate from level to level. After project termination, government resources and patient fees will be used to finance this system of coordinated public and private, curative and preventive health care. After renovation of 100 local Health Centers and construction of eight others, project efforts will concentrate on establishing logistic and supply systems in each zone. For this, the project will finance the purchase of jeeps and multi-purpose vehicles and cover the cost of initial medical equipment and supplies. Efforts will also focus on training, especially the training of Zairian trainers. By project end, 15 doctors, 300 nurses, 600 paramedics, and support and supply personnel will have been trained. Short-term training will be provided in fields such as data collection/analysis and health systems management and will consist of 3-4 months participation in on-the-job type situations in the United States or a third country.