Framework for preparing the Korea Health Development Institute's final report on AID project 489-U-092

Of late, CHA curative contacts have increased dramatically in all project areas and CHA curative contacts have increased as well. Town-level primary health units (PHU's) maintain excellent health records and along with county-level community health centers (CHC) possess ample, good quality equipment, although the PHU drug supply is excessive given the expertise of CHP's. Care has been upgraded by adding better-trained physicians to the program, constructing modern and specialty clinics, practicing immunization, and maintaining a structured referral system. Preliminary studies show that the user rate in the target areas has increased substantially to 64% and that average health costs in the project area were lower than in a control area not covered by the project. It was recommended to consider assigning physicians to CHC's which offer a more stimulating environment and from where physicians could direct specialty clinics, review drug inventories and remove superfluous medicines; give CHP's and CHA's civil service status and adequate pay and increase efforts to retain them; have the Korean Health Development Institute provide technical advice and administrative control over the replication of low-cost IHCDS's and have the GOK vigorously pursue alternative funding sources to continue the project after A.I.D. funding ceases. An outline for a final evaluation of the project is appended.