Child survival [: Egypt]

Evaluation covers the period from 1985-11/92. Lessons learned are discussed below. Every public health program must be designed to fit within the existing institutional context. This project is managed as a semi-autonomous program which means that special efforts need to be made to integrate its activities into the existing Ministry of Health (MOH) administrative structure and the existing service delivery system. The MOH leadership should plan early for the level of MOH support necessary to maintain post-project activities. A study to determine the funding requirements to sustain post-project activities has been initiated. Early attention to this most important issue is critical to the future of the program in Egypt. It is more important to emphasize the quality of services being developed than it is to attempt premature evaluation of the impact of these service. The project is working to improve service delivery across a wide spectrum of maternal and child health care areas. Particular attention needs to be focused on quality assistance in these programs. Effective, skills-oriented training is a key to sustainability. The CSP has trained large numbers of health providers and equipped 26 training centers in 19 governorates. The project"s management information systems (MIS) call for the collection of much more data than it is possible to analyze. The MIS is being redesigned to foster a greater degree of analysis and utilization of information at the periphery of the Health Care Systems. Involving the university community in strategy formulation, planning, research, and training is an excellent way to find talent and advocacy for the project. The project plans to strengthen the link between the MOH and universities. Establishing adequate services on a decentralized basis is essential to the success of the program. Delegation of responsibility for child spacing activities to the local level will establish improved commitment from local officials. The project is now applying this approach. Mass Media and Social Marketing are critical in mobilizing the public and in creating a better demand for child survival services or changing behavior. Private commercial expertise needs to be harnessed in order to produce high quality media materials and to ensure adequate air time in order to reach the largest numbers of people rapidly during the next two year period. (Author abstract) See also abstract of companion evaluation, PD-ABF-500.