Final evaluation report : Koutiala child survival project, Sikasso Region, Mali

Project activities were implemented mainly in the subdistricts of Koutiala Central and Mpessoba. The project's components included nutrition, diarrheal disease control, growth monitoring, maternal health, and immunization for children and women of child bearing age. From 1988 until 1991, the intervention area included 54 villages and the town of Koutiala; the immunization component was implemented throughout the district of Koutiala. Future interventions (1991 to 1994) will target the 54 villages in the Koutiala Central and Mpessoba subdistricts, including the town of Koutiala, and 6 new villages. The KAP survey carried out by World Vision Mali in Koutiala district had two purposes: (1) a final assessment of the immunization intervention in the entire Koutiala district; and (2) a baseline survey in the 60 villages of Mpessoba subdistricts and Koutiala Central, including Koutiala town. The WHO model of 30 clusters was used in the two subdistricts and an additional 30 clusters were taken from the rest of the district. For the CS III final survey on immunization, a total of 391 mothers were interviewed on their knowledge and practice in the whole Koutiala district. The results showed coverage for children of 12-23 months to be low -- only 26% were fully immunized. Mothers' knowledge about how many immunizations are needed, and at what age measles immunization should be given, was poor -- less than 10%. For the CS VII baseline survey, a total of 271 mothers were interviewed on the following topics: nutrition, diarrheal disease control, growth monitoring, maternal health activities, and immunization for children and women of child-bearing age. The baseline survey results showed a low level of knowledge across all the components of the project. In the nutrition component, only 5% of mothers were supplementing breast milk by six months. In the diarrhea component, only 8% of mothers surveyed knew that dry mouth, shrunken eyes, and decreased urine output are important signs/symptoms of dehydration. In the EPI component, only 22% of the children 12-23 months were fully immunized. The results regarding maternal care intervention were more positive than in the other interventions: 53% visited a health post during their pregnancy. The project staff recognized that they will need to focus their efforts on training and health education in the future as primary means to strengthen these interventions. (Author abstract)