Improving childhood health project (PROMESIN) : final report

The project aimed at improving household health security, with a focus on decreasing child mortality and morbidity. The project: (1) trained 100% of the health technicians from Health Region No. 4 in the Integral Attention of Infancy Prevailing Diseases (IAIPD) strategy; (2) trained 100% of institutional and community staff in the Integral Attention to Community Children (IACC) strategy; (3) trained 100% of health technicians in breastfeeding, community empowerment, water and hygiene promotion, reference system, and epidemiological surveillance; (4) trained health volunteers to serve as breastfeeding counselors, community animators, monitors and IACC monitors, epidemiological surveillance system and reference personnel, and community oral rehydration unit personnel; (5) equipped 30 health centers at the regional, area, and sectorial levels with filing cabinets, shelves, blackboards, television sets, VHS, and computers; (6) strengthened the information system for health technicians and health volunteers by providing printer forms, calculators, notebooks for information registration, and letter and legal size bond paper; (7) supported research on knowledge and attitude of mothers of children under 2, and on health staff knowledge and practices regarding integral attention to children, nutrition, and breastfeeding; (8) initiated a coordination plan with other NGOs; (9) developed an information, education and communication (IEC) plan and supported radio education; and (10) equipped 27 community oral rehydration units with chairs, tables, pots, and oral rehydration salts. Factors favorable to project success included project acceptance by the Ministry of Health (MOH) staff at the central, regional, zone, sectorial, and local levels; support from the municipalities; timely financing; support from CARE departments; and technical support from CARE"s ACD Program and Programming Team Technical Advisors (EQUIPROCARE). Constraints included five labor strikes at the MOH during the life of the project; the latest, on September 2001, lasted 3 months and affected the development of programmed activities due to the short life span of the project. The following lessons were learned: (1) The efficient partnership between CARE and the MOH showed the feasibility of successfully executing programs to decrease childhood mortality and morbidity. (2) PROMESIN"s experience and model can be expanded to poorer and more vulnerable municipalities where CARE works. (3) The community"s appropriation of a project is directly proportional to its participation in the project.