HEALTH SECTOR LOAN II

THIS PROJECT WILL CONTINUE & EXPAND THE RURAL BASIC HEALTH SERVICES PROGRAM (SBS) BEGUN UNDER HLTH SECTOR LOAN I (517-U-028). THIS LOAN (HLTH SECTOR II) WILL BRING AN ADDITIONAL 100 RURAL COMMUNITIES WITH A TOTAL ESTIMATED POPULATN OF 200,000 INTO THE SBS SYSTEM. THE STAFF OF THE COMMUNITY CLINICS AS WELL AS THOSE OF 20 AREA HOSPITALS WILL BE UPGRADED.DOCTORS FROM THE SANTO DOMINGO PEDIATRIC & MATERNITY HOSPITALS WILL INSTRUCT THESE PERSONNEL IN "REFRESHER COURSES" COVERING PREVENTIVE CARE OF MATERNAL & CHILD HLTH PATIENTS FAMILY PLNNG,CLINICAL MGMT OF HIGH RISK CASES, BREAST FEEDING,AND NUTRITION. ALSO,RURAL CLINICS WILL BE ISSUED EQUIPMENT INCLUDING STETHOSCOPES, SPHYGMOMANO-METERS,VAGINAL SPECULA,CHAIRS,INSTRUMENT CABINETS,SCALES,EXAMINING TABLES,RING OR SPONGE FORCEPS,EXAMINING LAMPS,FILE CABINETS,AND OTHER SIMPLE MEDICAL EQUIPMENT. IN ADDITION,400 COMMUNITY-LEVEL HLTH WORKERS (SBS PROMOTERS) WILL BE TRAINED. THE SECRETARIAT OF STATE FOR PUBLIC HLTH & SOCIAL ASSISTANCE (SESPAS) WILL TRAIN BOTH THE PROMOTERS & 20 HLTH EDUCATORS SELECTED TO SUPERVISE THEM. THE LOAN WILL ALSO FINANCE DEVELOPMENT OF SOURCES OF POTABLE WATER,SEWAGE DISPOSAL,AND HLTH EDUC FOR APPROX 160,000 PERSONS IN 500 COMMUNITIES,WITH AVE POPULATIONS OF 325. A TOTAL OF 26,500 LATRINES WILL BE CONSTRUCTED--ONE FOR EACH HOUSE IN THE 500 PARTICIPATING COMMUNITIES. IN ADDITION TO SUPERVISING HLTH PROMOTORS,THE HLTH EDUCATORS WILL BE RESPONSIBLE FOR PROMOTING COMMUNITY PARTICIPATION IN THE CONSTRUCTION,MAINTENANCE,AND APPROPRIATE USE OF WELLS & LATRINES. THE EDUCATORS WILL RECEIVE 40 DAYS OF TRNG IN COMMUNITY ORGANIZATION,COMMUNICATIONS,PREVENTIVE HLTH MEASURES,SANITATION,COMMUNICABLE DISEASES,FAMILY PLNNG,EDUC TECHNIQUES,AND SUPERVISORY SKILLS. TECH ASSIST WILL BE PROVIDED IN THE DESIGN OF THE HLTH EDUC TRNG PROG,AND IN THE SELECTION & EVALUATION OF THE TRAINERS.