BASICS/Senegal : country program review

BASICS has developed productive relations with key partners, including USAID, the National Service for Feeding and Applied Nutrition (SANAS), and the Management Science for Health project, and its regional advisors have played an important role in providing both technical and programmatic support to the program in Senegal. For its part, BASICS/Senegal, in addition to in-country activities, has participated in activities organized on a regional level, e.g., development of integrated management of childhood illness (IMCI), IEC (information, education, and communication strategy) development, and work in nutrition. SANAS"s capacity to plan and implement key child survival interventions has been enhanced through collaboration with BASICS. BASICS/Senegal has provided formal training opportunities to staff from SANAS and BRAN (unidentified acronym) in such areas as management, planning, IEC, and nutrition. Capacity building has also taken place through collaboration on various studies, research topics, and other joint ventures such as the development of the PROFILES program and presentation. District action planning is another instance of positive collaboration in which the process followed and imparted to counterparts may be as important as the product itself. BASICS/Senegal and SANAS have also worked together effectively to develop key policy documents, primarily in the area of nutrition. Several important model approaches have been introduced in districts. Examples include the project"s experience with the Preceding Birth Technique for measuring mortality among children aged 0-24 months and community nutrition and growth monitoring efforts in the Dioffior district. BASICS/Senegal proposes to follow a scaling up process with respect to the introduction of the MINPAK (a minimum package of nutrition-related activities aiming at improving the nutritional status of pregnant women and children) in a number of districts as well. Key constraints to program implementation include: (1) the inadequacy of key Ministry of Health (MOH) systems -- in particular supervision of routine activities, the health and management information system (HMIS), and the gathering of feedback; (2) the lack of oral rehydration solution (ORS) at service delivery points (though it is hoped that this situation will improve in the near future due to the recent introduction of ORS into the essential drug list and its incorporation into the Bamako Initiative pharmacies, along with a regional effort by BASICS, Population Services International, and Rhone-Poulenc-Rorer Pharmaceuticals to promote the marketing of ORS in the private sector); (3) expansion of the original BASICS/Senegal mandate to include increasing the capacity of Senegalese institutions to develop and manage child survival activities, developing a nutrition component, and introducing the Preceding Birth Technique, IMCI, and the MINPAK into Senegal; and (4) the absence of a plan for transferring program management responsibility to the MOH when the project ends in a year (the latter problem is especially acute since many of BASICS/SANAS activities are taking place as pilot activities in only a few districts in each of the four regions in which USAID-funded activities are focused). There is also a need to rationalize the yearly indicator reporting and develop a schedule of and means to collect the data needed by the Mission to prepare the annual R4. Finally, district action plans being submitted to USAID for funding are omitting certain types of necessary expenses (e.g., the recurrent costs of supervision) that are not expected to meet with USAID approval. However, since alternate funding sources for those same necessary costs are not identified, the work goes undone.