EVALUATION REPORT; MCHA TRAINING PROJECT; TANZANIA

ALTHOUGH A YEAR BEHIND THE ORIGINAL AMBITIOUS SCHEDULE, IT HAS ALREADY RESULTED IN A SUBSTANTIAL EXPANSION OF THE CAPABILITY OF THE MINISTRY OF HEALTH TO EXTEND MCH (MATERNAL AND CHILD HEALTH) SERVICES TO TANZANIA'S RURAL POPULATION. FOURTEEN OF THE EIGHTEEN TRAINING CENTERS PLANNED HAVE BEEN OPENED. THE TRAINEE TARGETS ARE REALISTIC AND WILL MAKE TRAINED MCH PERSONNEL AND SERVICES ACCESSIBLE TO 90% OF THE RURAL POPULATION BY THE EARLY 1980'S. THE TANZANIA GOVERNMENT IS GIVING TOP PRIORITY TO PREVENTIVE HEALTH IN ITS TOTAL HEALTH PROGRAM, AND MCH IS GIVEN THE HIGHEST PRIORTIY AMONG ALL PREVENTIVE SERVICES. COOPERATION AMONG ALL OFFICIALS INVOLVED HAS BEEN GOOD. THE DEGREE OF EMPHASIS ON SUPPORT TO THE MCHA TRAINING PROGRAM VARIES FROM AREA TO AREA. WITH FEW EXCEPTIONS, THE COOPERATION OF MCHA SCHOOL STAFF AND THE NEARBY DISTRICT HOSPITAL STAFF APPEARED EXCELLENT. THE PLANNED UPGRADING COURSE FOR MCH PUBLIC HEALTH NURSES IS OF HIGHEST PRIORITY BECAUSE OF THE LACK OF ADEQUATE NUMBERS OF TRAINED NURSES WITH MCH AND PUBLIC HEALTH SKILLS. THROUGH FY 1976, OBLIGATIONS UNDER THIS PROJECT HAVE FUNDED THE CONSTRUCTION AND EQUIPPING OF THE EIGHTEEN SCHOOLS, TECHNICAL ASSISTANCE, PARTICIPANT TRAINING, EQUIPPING OF RURAL HEALTH FACILITIES, AND RECURRING COSTS WHICH WILL BE TAKEN OVER BY THE TANZANIAN GOVERNMENT. THE MCHA TRAINING PROGRAM CURRICULUM IS CONSIDERED TO BE APPROPRIATE FOR PREPARING THE MCHA'S TO WORK IN A RURAL SETTING. THE EVALUATORS DISCUSSED AND MADE 19 RECOMMENDATIONS ABOUT TANZANIA, US AND OTHER DONOR SUPPORT TO THE MCHA TRAINING PROJECT; AND THE CURRICULUM, STUDENT SELECTION, SCHOOL STAFF, FIELD PRACTICE, PHYSICAL FACILITIES, AND PARTICIPANT TRAINING ASPECTS OF THE PROGRAM.