LOFA COUNTY RURAL HEALTH EVALUATION REPORT

This final evaluation, attached to a PES Facesheet (DOCID: B6690125001501), covers the period 7/75-6/79 and prepared by a joint USAID/Government of Liberia (GOL) team, is based on site visits, a review of project files, and interviews. Health facilities have been well constructed and staffed, and possess adequate supplies of drugs, equipment, and recording materials; an operational county medical depot has also been established and equipped. Delivery of health services has increased markedly, especially in the areas of family planning; maternal child health (MCH), e.g., prenatal and under-five years of age visits; and, with the help of the Expanded Immunization Program, immunization coverage. The project's reorientation in 1978 had a positive impact, leading to well construction in communities, establishment of village health committees, and training of traditional midwives. The MCH supervisory team, the counterpart, the community health physician, and the teacher/trainer benefitted the project greatly. Supervision of health posts and centers, particularly in Lower Lofa and Konia, was inadequate, however. Cooperation between GOL and non-GOL health organizations, while good, could be improved. Although important progress was made, it is doubtful whether the project notably improved people's health status. This is because the project design was institution, not people oriented -- a mistake that must be avoided in developing the national health plan. Recommendations include: (1) A.I.D. should terminate the project in 9/79, as planned, but continue teacher training and public health assistance. (2) Preventive health services and health education should be given greater emphasis. (3) The expanded immunization program should be carried out. (4) The Project Trust Fund should be continued, but under Liberian management. (5) Uncommitted project funds should be used for commodities and additional participant training. (6) Project trainees should be assigned only to the Lofa County health program.