Lesotho combatting childhood communicable diseases (CCCD)

The evaluation covered the period 1986-8/88. The project has helped achieve high immunization rates in children and has helped reduce diarrhea admissions and deaths through promotion of oral rehydration therapy (ORT). Measles immunization coverage for children aged 12-23 months is 78% -- one of the highest in the world. In addition, the Ministry of Health (MOH) now encourages sound diarrhea case management at ORT units in 90% of hospitals. At the institutional level, the decentralized training program supported by the project is a viable program that has trained an impressive cadre of central health service area and health center/clinic trainers and integrated CCCD topics into general training activities. Also, the MOH"s Health Education Unit, with support from the HEALTHCOM project (9311018), has made major institutionalization efforts through staff training, equipment procurement, and the development of communications strategies. The MOH"s Health Statistics Unit has made dramatic progress. On the down side, although the project is generally well managed, there is need to address problems of staff shortages and transfers, strengthen supervisory and management skills, make adequate use of funds for operational research, strengthen the donor coordination mechanisms of the MOH"s Health Planning Statistics Unit, and undertake internal evaluations.