Evaluation of the PRISMA project # 527-0311 : identification of high risk families for child mortality in Peru

A risk score was developed in both a peri- urban slum population and a rural high altitude population, and was used to identify the "at risk" families, so that interventions could be targeted to them. Community health workers (CHW's) were elected by the communities and were trained by professionals hired by the project. Medical professionals in the Ministry of Health were instructed in the use of the risk strategy through both seminars and technical meetings. The majority of community interventions were educational by nature, although there were a series of activities both organized and run by community leaders and community health workers with project help, such as the construction and implementation of three health posts, a health post based nutritional rehabilitation program, a community laboratory for the detection of tuberculosis, community-based oral rehydration units, a latrine installation program, a garbage collection system, and mini-immunization campaigns. All material needs for these programs were obtained from a variety of donor sources outside the project. In this final report, we will describe in detail the methodologies used by project personnel to accomplish all project goals and objectives. The use of the risk score card by CHW's is evaluated and the final section of the report includes a discussion of lessons learned. One of the most important products of this project is that it has influenced the development of a risk targeting strategy for an MOH food distribution program. This program in turn has developed at operational level a national awareness, especially in the public sector, that targeting scarce resources to the population most in need of these resources has a greater potential for impact on child survival indicators. (Author abstract)