Final evaluation of USAID/Senegal's family health and population project (project no. 685-0248)

The evaluation covers the period 4/85-5/91 vs. a PACD of 9/92. It was constrained by a number of factors, including lack of previous evaluations, missing and inaccurate data, and the impossibility of examining all of the project's many components. In effect, the evaluation is a snapshot of the project at the time of the evaluation. Despite implementation problems, the project has contributed significantly to a dramatic improvement in Senegal's FP environment. Generally, the project increased knowledge and practice of FP planning; introduced FP services into clinics throughout the country; trained health workers and managers in various FP areas; developed an important FP program in the private sector; and increased the awareness of Government of Senegal (GOS) planners and policy makers to the importance of demographic factors in development planning. As a result of these efforts, a National Population Policy was adopted in April 1988 and the President of Senegal signed a National FP Policy into law in March 1990. More specifically, from 1985-1990, the number of active contraceptive acceptors in public clinics increased on an annual average of 28% and in the private sector on an annual average of 44%; and combined public and private sector clients increased from 8,500 to 39,000. However, the rate of increase of active clients slowed from 1988 to 1990 in the public sector to only 14%. Also, against the original project goal of 200,000 acceptors by 1992, there were, in 1990, only 70,107 acceptors in all sectors using modern contraceptive methods. This may be due to the fact that the project was overly optimistic given its time frame, budget, and Senegal's cultural and policy environmental and deteriorating economy that will reduce the GOS's ability to support a follow-on project under standard USAID arrangements. Finally, project management and supervision have been weak on the part of both the GOS and USAID. The GOS is aware of these management problems and is moving to solve them in the soon to be integrated National FP Program. Individual chapters of the report cover: (1) project administration and management; (2) information, education, and communication (IEC); (3) FP clinical services; (4) treatment of sexually transmitted diseases and infertility; (5) biomedical and psychosocial research; (6) construction and renovation of infrastructure and equipment maintenance; (7) contraceptive logistics management; (8) women in development projects; (9) FP service statistics, research, and evaluation; (10) the private and para-public sector (PPPS) and contraceptive social marketing; and (11) the demographic data base. The report also includes two summaries: an extensive executive summary, which contains a cross-cutting synthesis of the substantive chapters; and a Summary of Findings and Recommendations contained in those chapters.