Final report of the health planning advisor, development of health services, Syria project

Final contractor evaluation covers the period 11/77-2/81. Although too ambitious for a 1-year effort, major project objectives were achieved. A 3-year work plan outlining the Planning Department"s major activities -- evaluating the health information and health care delivery systems and other MOH programs -- was approved 12/77, but because of MOH concern that the work plan spanned 3 years and the contract only 1 year, the contract with Medical Services Consultants, Inc. (MSCI) was extended. Routine data collection procedures were shown to be seriously flawed. MSCI specified methods for upgrading these procedures and, in addition, conducted studies on the status of zoonotic disease in Syria and on the feasibility of developing an epidemiological survey team. Investigation of the health care delivery system and a systems analysis of various MOH operations indicated a major logistics planning problem. Although the basic structure of the MOH"s central logistics system was acceptable, it utilized poorly defined criteria for reviewing supply requests; modifications were recommended. The systems analysis also revealed that staffing was insufficient to meet the needs of the MOH"s 5-year plan. To build a substantial training program, areas of need were identified, four individuals and two nurses were enrolled in M.S. programs in public health, and a curriculum was designed. However, the subsequent training of 37 people for middle- and senior-level management positions was suspended because of insufficient funds. Problems encountered included delays in the MOH"s appointment of a counterpart to the MSCI health planning advisor, leading to the existence of the Planning Department on paper but not in actuality; the MOH"s failure to establish or fund the requested planning positions; and difficulty in recruiting trainees due to a lack of qualified candidates and financial and bureaucratic barriers. It is recommended that these factors be taken into consideration in the design of future projects.