Final evaluation of World Relief Corporation's child survival grant

The evaluation covers the period 1/88-1/91. CSS's child survival project is implemented in conjunction with an income generation program that provides loans to increase villagers' standard of living. A 4% premium on interest (16% vs. 12%) is charged on loans in participating unions to offset recurrent costs. Project activities include family planning promotion (including distribution of orals and condoms); distribution of oral rehydration solution, food supplements for very malnourished children, and vitamin A; growth monitoring; and promotion of government immunizations (e.g., transporting vaccinators and vaccines to village camps). The project has had a significant impact. Immunization coverage is more than double that in adjacent unions; contraceptive use is significantly higher; and deaths from diarrhea much lower. The community actively participates in project activities, ensuring program sustainability. A cadre of village volunteers, selected by the community, has been trained to work in the program. The CSS staff, all Bengalis, view employment in the program as a career opportunity. This keeps costs down and also enhances continuity. The staff are clearly committed to village development in southwestern Bangladesh. Also, CSS has a strong management structure and is skilled in attracting foreign funding. CSS could improve this already effective project by adding a public health specialist to its team, developing a comprehensive management information system, and increasing health education and training efforts.