Evaluation of phase II of the MCH extension project in The Gambia and Benin

Purpose of Phase II was to replicate successful Phase I activities in at least two other areas. Team reviewed all AID/W and field documents; met with Ministry of Health (MOH) personnel; & conducted onsite observ & disc w/US, Gambian, & Benineise proj technicians. In both countries, utilization of MCH services has been good, although FP services were less well accepted. Programs have been established at Kuntaur, Kerewan, & the Royal Victoria Hospital in the Gambia. At pilot site trng center for community health nurses, the first 15 grads have been posted; current students enthusiastic about nutrition, public health, nursing skills, & other areas of study. Host country not fully prepared to take on full academic, functional, & financial responsibilities of trng ctrs. Advanced MCH/FP trng is needed for admin-level physicians, & mgmt/health admin trng is needed for key MOH personnel. Methods of completing & storing standardized medical records are inadequate for the volume of Gambian patients. Data is collected successfully but must be hand-tabulated once it reaches MOH. Roads & transport are deficient & there is a lack of supplies due to dependence on govt purchase & other donor input. health & malnutritn, although somewhat simple, reached intended audience. 12-month extension of activities recommended. In Benin, ten ctrs are operating well in all aspects. Host country appears ready to accept full responsibility for continuing project activities. An effective sys of record keeping was established, & will be implemented shortly to serve output of data collection analysis. Transport, communic, & supply sys operating effectively. Programs on envir health & malnutrtn using sophisticated A-V methods in conjunction with lectures, group exercises, & discussions were well received & reached projected populations. Scheduled phase-out of activities recommended.