Hanang district health project

Evaluation covers the period 2/80-12/80 and is based on site visits and on a meeting of A.I.D. and grantee, Coordination for Development (CODEL), personnel. To date, 96 village health workers (VHW"s) have received 10 months training in Babati, 28 more will finish training in 1/81, and the final 45 will finish in 11/81. A total of 169 VHW"s will thus be assigned to 75% (108) of HD villages. However, training of village health leaders (VHL"s), the lowest level of health personnel, has experienced problems (e.g., few classes and poor attendance). Despite modifications in health education methods, VHL effectiveness is minimal and the entire approach to using this tier of personnel has been called into question. In addition, 12 maternal/child health clinics have been established, and first aid boxes are being set up, although obtaining supplies is a problem. Nutrition and health surveys and a district census are complete, data have been collected monthly on childhood diseases and health education class attendance, and a health questionnaire has been completed in all villages. Inclusion of data collection techniques in VHW training will assist in the institutionalization of these activities. Although both the project director and systems analyst have resigned, another director is being recruited in Tanzania and two staff members have been trained in systems analysis. The post of District Medical Officer (DMO), filled by many people, has also been vacant for several months, and the approaching end of the project (11/81) may lead to further loss of personnel. In addition, a $25,000 budget shortfall has resulted due to higher than expected gasoline and vehicle maintenance costs. It is recommended therefore that: (1) CODEL hire a project director already living in Tanzania; (2) USAID/T seek funds to cover the funding shortfall; and (3) project staff elicit support from district health personnel, assist in supervising VHW"s, effect the assignment of a permanent DMO, and collect data to document specific VHW-initiated activities.