DANFA RURAL HEALTH PROJECT EVALUATION

This special evaluation covers the period 1/1/69-9/1/79 and is based on an onsite review. The Danfa project consisted of three primary activities -- health services delivery and evaluative research, participant training, and institutional development. In addition to the Danfa center, three satellite clinics were set up at Oyibi, Berecuso, and Abokobi. Priority was given to mothers and children. Traditional birth attendants, village health workers, and health education assistants were trained to assist the center health workers. A mass immunization program, while failing to attain its goal of reaching 80% of the children in the target area, did demonstrate the greater effectiveness of multiple antigen innoculations over single antigens. The malaria chemoprophylaxis program was more successful in reaching school-age children than in reaching pre-schoolers (who had to be brought in for treatment). A number of epidemiological studies were conducted, and polio was found to be a significant problem. Nineteen Ghanaians received training in the United States, mostly at UCLA. Project problems for the most part related to the evaluative research component. For example, only limited use was made of the village health survey--which proved to be a very costly undertaking. Although project personnel claimed that the family planning survey revealed a significant increase in the number of acceptors, failure to provide age-specific rates or to designate the total number of eligible women made this claim difficult to substantiate. Heavy migration rendered the results of the vital events registration and survey questionable. Furthermore, the extent to which the Danfa area is typical of Ghanaian rural communities is not known. This document contains a lengthy series of recommendations relating to health services delivery, family planning, health education, evaluative research, cost assessment, training, program continuation, linkages with other agencies, institutional development, and project management.