Final evaluation report : Loitokitok child survival project, Kenya

The project has made great strides in improving health and nutrition in the community. For example, full immunization coverage is well above 78%, and has been maintained at that level since the midterm evaluation (MTE); in fact, less than 5% of the households reported a case of measles in the previous year. More mothers know how to prepare and use oral rehydration salts (ORS) than did at the time of the MTE; 71% had used ORS to treat their children during the last episode of diarrhea, well above the targeted level of 50%. Clinic attendance for antenatal services came to about 80%, and 58% of the mothers (compared to 50% targeted) had received at least two doses of tetanus toxoid vaccine before the last delivery. Attendance rates of children at growth monitoring sessions have increased steadily since the inception of the project. At the time of this survey, 35% of the children were attending at least one session every second month, compared to 15% at the MTE. The proportion of children whose weight was below 60% (weight-for-age standard) of the median National Council Health Services (NCHS) was 2.3%. The use of modern methods of family planning is still at 10%; however, many more women expressed a desire to use contraceptives. The desire for more children and lack of awareness about the existing methods of contraception were the reasons given for not practicing contraception. The use of trained traditional birth attendants and community health workers was much lower than expected. The survey was also not able to collect reliable results on important vital statistics. There is still much room for improvement in the health status in the community. More emphasis should be placed on developing mechanisms that will secure the sustainability of project"s activities and achievements; continuous community involvement and participation of both local leaders and government agencies working in the area are key elements in achieving project sustainability. (Author abstract)