Combatting childhood communicable diseases

Evaluation covers the grant"s first year (1/85-12/85) and was conducted by personnel internal and external to the project. Despite some shortfall due to an AID-approved shift in priorities, progress in training LDC personnel has been satisfactory. Activities have included courses at Lagos and Lome for 30 primary health care trainers and supervisors in systematic course design, community mobilization, and management; senior epidemiology courses at Nairobi and Bamako; two courses for refrigerator repair technicians in English and Portuguese, respectively; a mid-level diarrheal disease course for English-speaking participants; and ORT training for 15 physicians (4 more will soon receive similar training). The Governments of Malawi, Zaire, and Cameroon have agreed to have WHO Training Centers for ORT in their countries, and preliminary work on these centers is underway. (ORT centers not supported by A.I.D. already exist in Dakar and Addis Ababa, and one is planned for Luanda.) Planned activities authorized by a grant amendment include, inter alia, courses in basic malariology and malaria control, training of 20 persons at the Dakar Oral Rehydration Therapy Center, a meeting of Francophone managers of Expanded Programs of Immunization, revision of senior-level French epidemiology course materials, and purchase of materials for the 1986 Bamako and Nairobi senior epidemiology course. On the negative side, progress in the health information component has not been significant, evidencing a need to reconsider implementation arrangements. A review of reports (not funded by the project) from Cameroon, Togo, and Zimbabwe on the managerial process for national health development leaves unclear the direction of health information systems activities under such a managerial system. The evaluation team was unable to review a report on available epidemiological data. Action decisions are that: (1) AID/W schedule quarterly implementation reviews of grant agreement performance in Brazzaville; (2-3) WHO/AFRO provide AID/W with additional reports and revised proposals for health information systems activities, and review the need for managerial and administrative assistance in project implementation; and (4) the grant agreement be extended at increased funding for the period 4/86-12/87. A list of activities proposed for the latter period is included. AID/W"s decision on these activities will occur in 4/86.