COMPOSITE PROGRAM FOR WOMEN & PRESCHOOLERS IN KERALA, INDIA

Evaluation covers the period 3/80-3/81 and is based on document review, site visits, and interviews with USAID and Cooperative Americans for Relief Everywhere (CARE) personnel and project beneficiaries. With the opening of 100 AID-financed and 250 CARE and other donor-financed day care centers (DCC"s) and the provision of Title II commodities to 10,000 preschoolers and 3,000 pregnant or lactating mothers from rural poor families, the CPWP has been greatly accelerated. DCC"s were delivering an integrated package of nutrition, health, and education services. Food (e.g., bulgur, oil, milk) was provided six days per week; twice per day for severely malnourished children. However, rations were not always nutritionally equivalent to meals children could receive at home. Two nutrition education training camps were organized for mothers, but for significant improvements in dietary practices to be realized, classes must be more frequent. Latrine construction was not completed at each DCC, but CARE indicated that it would ensure completion. Although most children have been immunized, health services remain the weakest part of the CPWP. It is recommended that: (1) CARE provide USAID with an evaluation by 3/82 describing the project"s impact on increasing caloric and protein intake, improving dietary practices, and reducing the incidence of communicable diseases among preschoolers; (2) salaries and training periods for DCC teachers be increased to assure proper motivation and preparation; (3) rations be increased to 50% of the daily nutritional requirements; (4) DCC"s be assured monthly visits by Auxiliary Nurse Midwives; and (5) better scales be purchased to ensure accurate weighing. The project has taught that programs such as the CPWP, when given outside assistance, can be conducted both by and for the beneficiaries. However, it is unrealistic to expect already overworked health care personnel to provide services to DCC"s unless the entire health system is strengthened.