Kitui primary health care project, phase II

The evaluation covered the period 6/82-4/85 and was based on document review, visits to clinics, and interviews with mobile teams, community leaders, and members of the Diocese of Kitui and of other organizations delivering health services in the project vicinity. With vaccines regularly supplied by the Ministry of Health (MOH), the program is providing primary immunizations to children under 5 and to pregnant women, and has made some effort to administer booster immunizations and to improve hygiene in the home. The program has also: provided women with pre- and postnatal care (with health education at clinics a prerequisite to these services); established health committees to augment and reinforce development and project activities; trained traditional birth attendants; initiated school health programs; and provided training in natural family planning (NFP) and trained couples as NFP teachers, with information and referral for other methods available as appropriate. Despite the environmental and climatic constraints of the project catchment area, service delivery by the four mobile teams has been consistent and timely. On the negative side, a recent and very severe widespread drought led to migration and thus decreased prenatal attendance and child immunization in some areas. Also, planning and administration on the part of the Diocese of Kitui have been insufficient due to competing demands on the Diocese"s project manager. Catholic Relief Services, which sees itself only as a conduit of funds for this project, should have been more involved in project planning, management, and leadership. Due to cancellation of the planned Kitui Rural Health Project (6150206), the transfer of program activities to the MOH, which was to have been accomplished under that project, never took place. This failure has placed an undue burden on the Diocese. The main action decision is to extend the project in order to make implementation more effective and facilitate the transfer of activities to another donor.