CARE primary health care unit review : final report

The PHCU has been very effective in providing support and advisory services to overseas offices and staff with whom it has had direct contact. However, overseas personnel having minimal or no contact with the Unit are relatively unaware of the quality of its work and services. In addition, several CARE personnel appeared to be frustrated regarding the role of PHC in the total CARE program. While the organizational structure in New York tends to be hierarchical, CARE"s overall organizational structure is decentralized, with considerable authority vested in Country Directors. As a result, planning mechanisms provide for consolidating country and Unit plans rather than integrating them. Child survival projects have strengthened CARE"s PHC expertise due to their rigorous design, planning, and evaluation demands and by the addition of technical staff. However, the data available from these projects, though extensive, have been underutilized for several reasons: the projects are management- intensive; research costs are not covered by grants; and the activities have failed to sufficiently involve social scientists and writers. The PHCU must address this problem so that it can apply lessons learned from past activities to future health initiatives. The PHCU should make its services and successes more visible to others, particularly to field staff, and should also consider spending more time on donor relations and funding opportunities. The results of the questionnaire used in preparing the present evaluation could provide a basis for PHC planning. Also, given the new emphasis on integrating population messages into CARE programs, the Program Department may wish to experiment with integrating the planning process across units (though this would require a substantial restructuring of field offices). CARE is in a good position to consider three, mutually reinforcing options through which to carry out its PHC work in the next decade: (1) continue to implement child survival projects as a major activity; (2) develop intersectoral health-related activities; and (3) explore the use of women as health care providers as an integrating program theme.