Final evaluation of the Peace Corps guinea worm eradication program

Originally designed for 10 countries, the program now includes 11: Benin, Cameroon, Central African Republic, Cote d'Ivoire, Chad, Ghana, Mali, Mauritania, Niger, Nigeria, and Togo. A total of 74 volunteers are currently active in the program; over half of these combine Guinea worm eradication with complementary tasks in general health education, water supply, and community development. Overall, the program met its objectives. The level of outputs achieved was high, and efforts in the field were especially notable. Moreover, where local surveillance data are available, a tentative correlation is permissible between a decline in the incidence of the disease and the efforts of Peace Corps Volunteers in the area. Some weaknesses in program planning, management, and design, now in the process of being corrected, were offset by expectations exceeded elsewhere. Most important, however, is clear evidence of a growing momentum in participating countries and their respective Peace Corps posts as the eradication target date of 1995 draws near. Every post engaged in the program has expressed the conviction that Guinea worm eradication activities should continue. Given the limited core funding available within the Peace Corps for water and sanitation activities, an extension of financial and technical support will be required to consolidate and sustain present gains and to permit the planned increase in volunteer effort. Of the lessons learned from the PC/GWEP, two stand out. One is that the community-based, person-to-person approach to health education can be effective in encouraging health-seeking behavior. The other is that, in the view of many persons active in Guinea worm eradication throughout the decade, the entry of the Peace Corps into the campaign was a watershed and the beginning of a global mobilization effort. (Author abstract, modified)