DANFA RURAL HEALTH PROJECT EVALUATION - GHANA

This comprehensive, final (1970-79) evaluation was conducted by a contracted evaluation team who reviewed project reports and numerous papers and interviewed key project participants. The project was highly successful in extending primary health care services to the target area villages and in the areas of participant and in-country training and institutional development. Unfortunately, however, summative evaluation activities as well as other operational research activities could not be completed. This incompletion limited policy formulation, service delivery modalities, and overall project credibility. Until project data are finally interpreted, the Government of Ghana will be severely handicapped in its health planning and primary health care strategy implementation. Major problems with the evaluation component in specific activities included the following: Data of the Village Health Survey were expensive to collect and only limited use is made of them to assess the project"s overall impact in improving health status. The Health Practice Survey reported changes in several health practice areas -- both good (BCG vaccination and adequate human waste disposal for children under six) and bad (smallpox/measles innoculation and adequate adult male human waste disposal) -- for which no sufficient explanations were provided. Significant migration in the four project areas rendered the results of the Survey and Registration of Vital Events questionable. No data were available to substantiate evidence of differences in demographic characteristics of project areas. Numerous recommendations are provided in the areas of health services/family planning delivery; health education program; evaluative research; cost assessment; participant and in-country training; traditional birth attendants; program continuation; linkages with other agencies; institutional development; and project management.