DEVELOPMENT OF HEALTH SERVICES

This final evaluation covers the period 7/1/78-8/1/80. No methodology was specified. No health planning unit was established due to MOH"s failure to establish and fund agreed-upon project positions, to provide a suitable counterpart agent to assist the project component advisor, and to regularly produce the required number of qualified trainees. MOH evidently prefers its current crisis-oriented management system over any sort of planning unit. The health survey was developed, tested, and operational in five mohafazats by 10/79. There were considerable delays, however, due to the 6-week absence of the MOH Deputy Minister (who alone could approve the final questionnaire) and the replacement of the MOH printing press, which took two months. The position of biostatistics trainee was never filled. The survey"s continued operation is doubtful, however, once it is left totally in Syrian hands. The maintenance/repair unit has been the most successful of the project components. With help from a strong counterpart agent, equipment was secured, a workshop and mobile unit were established, and management systems were designed and partially installed. Shortfalls included the MOH"s continual failure to provide adequate project staffing and to increase the number of trainees. This component is expected to function effectively after the project has ended. Project shortfalls are due to inefficiency, bureaucratic tendencies, and backwardness on the part of the MOH. USAID, however, is to blame for its hurried obligation of project funds before the health planning and survey components were adequately prepared. Although the first evaluation demonstrated MOH shortcomings, the USAID project manager apparently did not advocate project termination or scaled down objectives. USAID ignored its own advisors and failed to address project issues, indicating a desire to preserve the project at any cost.