Child survival

A U.S. coordinating PVO (C/PVO) will implement the project, which will support CS service delivery by the public sector Secretaria de Estado de Salud Publica y Asistencia Social (SESPAS) and by U.S. and indigenous PVO"s. The project will primarily support basic CS services that are provided via community health promoters (HP"s). Each HP will teach 60-80 families about CS interventions through monthly home visits and will provide referrals for serious problems. HP services will include (1) providing growth monitoring and related maternal/child nutrition and health services/education; (2) teaching families how to prepare oral rehydration solution, and providing them with oral rehydration therapy (ORT) packets; and (3) teaching families to recognize the symptoms of acute respiratory infection and methods to prevent its spread. In coordination with A.I.D.-supported family planning (FP) and immunization projects (5170229 and 5170242), the HP"s will also distribute vaccination cards and provide FP information and contraceptives. At the same time, the C/PVO will implement a wide range of service improvement activities for SESPAS and participating PVO"s, with particular focus on education, supervision, training, and management. The C/PVO will, inter alia: (1) provide TA in diarrheal disease control, health care planning, training methods, management information systems, social marketing and mass media, etc. (2) develop health education materials; (3) provide training to some 1,500 HP"s and HP supervisors and to medical personnel and health administrators; (4) upgrade supervision of the HP"s by establishing a supervisory system with clear worker performance goals for each level; (5) conduct operations research; (6) develop a mass media campaign; and (7) implement a logistics support system and a health information system to track progress at the family level (including family health records, vital events registers, and HP activity reports). SESPAS" health service centers (e.g., hospitals, clinics, supplementary feeding posts), while not the primary focus of the project, will also benefit from these support services. Amendment of 2/21/91 extends the PACD to 6/30/93, increases funding by $1 million, narrows the range of project activities, and replaces the C/PVO with a contracted implementing agency, which will operate under closer USAID supervision. The new project purpose is to create a model integrated public/private CS health delivery system in 12 local PVO"s and in 3 SESPAS health regions. The proposed system will include interventions in: diarrheal disease control/ORT, immunization, and breastfeeding and birth spacing promotion. The project will reach 60% of families in the targeted regions, providing health services to 140,000 children aged 0-5 and 105,000 women aged 15-49. (PD-KAV- 412)