Evaluation of ACSI-CCCD project, Ivory Coast

External evaluation covers the period 6/85-5/87 and is based on document review, site visits, and interviews with involved personnel. The project is off to a somewhat slow start, although significant progress has been made in certain areas. Major achievements have been: (1) completion of draft workplans; (2) elaboration of training modules for the mid-level management course and of guides for paramedical training in the project's three major technical interventions - immunization, diarrheal disease control (DDC), and malaria control; (3) development of a training strategy; (4) implementation of 2 training of facilitators courses and 2 mid-level management courses; (5) completion or initiation of 6 operations research projects; (6) development of a national malaria control strategy; and (7) beginning of centralization of health statistics in the Direction of Public Health and Population (DPSS). However, a number of problems have been encountered, some of which were identified earlier and have not yet been corrected. For example, national plans have been drafted for DDC and malaria control, but they have certain weaknesses which need to be addressed; there has been no progress in locating a French-speaking yaws consultant; the Project Agreement has not been amended to reflect revised training goals; feasibility studies of alternative health care financing have not been performed; nor has documentation concerning the host government's monetary contributions been adequately clarified. The procurement process has begun for certain materials and needs to be undertaken for others. Other more general problems which continue to affect project progress include the difficulty of integrating project activities into the existing Ministry of Public Health and Sanitation (MSPP) structure; inadequate planning at the central MSPP level; and lack of support for the project from REDSO. There are also a number of more specific technical problems. Agreement needs to be reached by A.I.D. and the MSPP as to exactly how the project can contribute to improved child health care in the Ivory Coast. In addition, issues such as the DPSS's lack of support for project-related activities will have to be addressed, and Ivorian project and technical coordinators must be permitted to play more active roles. Other recommendations address planning and management, health information systems, support systems, immunization, DDC, malaria control, yaws, training, and health education. (Author abstract, modified)