INTEGRATED RURAL HEALTH SERVICES

Evaluation covers the period 3/79-7/80 and is based on project data, and data obtained from a village volunteer census and from the MOH statistics department. Although 56% of the revised target of auxiliary nurses, 37% of the community health workers, and 54% of the midwives have been trained, training has been impeded by MOH training personnel who acquired additional tasks and by a complete change in the Mission"s health staff. The three training centers are virtually completely operational -- one is awaiting furniture and teaching aids and one requires minor modification. The training program was reviewed by the Department of Nursing, and the curriculum is being revised. Teaching materials, including training manuals, have been designed, but additional financial support is needed to continue their preparation. Project funding will be reviewed to determine if funds can be transferred from other line items to the educational materials budget. A contract was let to evaluate the extent to which traditional midwives retain and apply the techniques taught them. The methodology for this evaluation has been developed and pre-tested; the results are being analyzed. The major problem encountered was the uncertainty the project"s priority for the MOH due to the change of government leadership, a change which has led to an increase in non-training duties for MOH training personnel. Discussions will be initiated with MOH representatives to lessen the anciliary duties of training personnel to allow them to train village volunteers. The project taught that modern, hygienic methods of child delivery are culturally unacceptable in some communities, and that clinicians may have lacked sufficient knowledge of social standards and practices. A social scientist probably should have assisted in the design of the training programs.