Botswana health services development

Evaluation covers the period 11/79-2/81 and is based on document review, interviews with project and MOH staff, and a site visit. Good progress has been made. Training has commenced for family and public health nurses, and an improved curriculum (especially in regard to improved teaching) for enrolled nurses is now being tested. Overseas training is being provided for one teacher in the latter program and for five teachers in the former two programs. National health education and nutrition plans have been developed, and new facilities built in the respective MOH units. A new 2-year training program for nutrition educators/nutrition assistants has been initiated and nutrition education has been strengthened in all teaching programs for paramedical personnel and at the primary school level. A senior health educator has returned from overseas training (two more are being trained) and a Motswana home economist is functioning in the MOH nutrition unit. Nutrition research is in progress. Unfortunately, the inability of host country ministries to agree on roles and salaries for senior level health administrators has prevented implementation of the training program for these personnel. If no agreement can be reached, other ways to strengthen this component should be sought and financial inputs reprogrammed. Project experience has shown the need to: develop team identity prior to arrival in the field; make sure that USAID"s are prepared to offer assistance on large and technical projects; and make sure that regular team meetings are held in projects involving numerous parties. Action decisions are to: hire a short-term consultant to improve educational communications; specify health educational planning objectives; have a Motswana fill the position of Project Coordinator after departure of the current coordinator; select a Chief of Party from incoming personnel; secure as soon as possible the permanent support services promised by MOH; and, upon the completion of the Senior Nurse Educator"s tour, review her revised job description and determine whether an additional Nurse Educator is needed.