Final report for the Papua New Guinea child survival support project (USAID contract no. 492-0017-C-00-0073-00)

The project developed and implemented several interventions in the delivery of maternal and child health services in PNG. The following are some of the results. (1) A 10-step tool and training method, which enables rural health workers to accurately and rapidly diagnose and treat the main causes of child death and disease, has been developed. (2) A low-cost, economically sustainable health worker training and supervision, and community education model has been established in 2 provinces and will be implemented in the other 18 provinces. (3) A simplified provincial- and district-level financial planning and management system will be implemented in all provinces by 1996. (4) A multisectoral alliance has been created to develop a national consensus on child survival and maternal health. (5) Solid health sector donor coordination mechanisms have been established. (6) A strong National Child Survival Secretariat has been created to lead and manage the multisectoral National Child Survival Program. Child survival and maternal health are now high on the national agenda. (7) A final external evaluation urged USAID to replicate the project"s training model and training materials in other child survival projects. Lessons learned include the following. (1) Although expatriate advisors made every effort to transfer technology through training and TA, having local professionals on board would have made the project more accessible to local professionals and would have made technology transfer easier. (2) Communication between program planners, managers, researchers, and outside consultants is key to the creation of well-formulated operations research. Research projects need to be monitored closely to ensure that appropriate information is collected and that findings are presented on time. (3) Rather than being abandoned, as per the Department of Health"s (DOH) original plan, the Regional Support Units should be strengthened, since they work closely with the health workers. (4) With the use of appropriate training methodology and materials, community volunteers can be effectively trained to identify symptoms that require medical attention. (5) Logistics management problems were found to be various and complex and need to be resolved by the DOH if the project is to be fully effective. (6) While location of the project in the DOH building is helpful in transferring ownership of the project to the DOH, it does not guarantee that the project will be sustainable. (7) The project"s most important contribution to improving maternal and child health was the launching of a comprehensive Child Survival Crash Program. However, limited PNG government resources, which will be exacerbated by the project"s early termination in 3/95, may preclude the Program from fulfilling its potential.