Kibwezi rural health care (AMREF)

Final PES covers the period 8/79-3/83 and is based on a special evaluation (XD-AAP-079-A). After a 6-month extension, most project objectives were achieved. As part of the Kibwezi Rural Health Scheme a health center was built/equipped (after an initial delay) and has operated for nearly two years at full capacity, handling 3,000-5,000 outpatients and 40-50 inpatients per month and holding weekly maternal/child health, family planning, and mobile outreach clinics. Also, 91 community health workers (CHW"s) were trained and deployed, refresher courses were held for division health staff, and progress was made in integrating division health services. Project support (e.g., salaries, overseas training, office equipment) improved AMREF"s management, learning, and information systems, enabling AMREF to increase allocated funds, project diversification, geographic area covered, and staff. AMREF now manages 33 projects, all affecting the health of the rural poor. Two staff members received M.P.H. degrees from U.S. institutions; more than 19 RHS reports documenting AMREF"s experiences were distributed. The learning resources component expanded teaching materials development and production. Four of the projected 12 training manuals for rural health workers were completed and five more will be published this year; three manuals were translated and two health journals, AFYA (for rural health workers) and Defender (for the general public), were published and distributed. More CHW"s were needed than originally planned due to a scattered population and restricted mobility, and there were attrition problems among those trained. Government of Kenya Ministry of Health (MOH) involvement was less than expected, and the anticipated MOH phase-in did not occur. Also, community involvement was hampered by the 1980 drought and famine. Progress is being made in correcting some of these problems.