MALARIA CONTROL PROJECT, NO. 391-0424, TERMINAL EVALUATION

This terminal evaluation, which covers the period 10/76-12/80, is based on an indepth review of previous project documents and of reports, field observations, and studies made by the World Health Organization (WHO), and on a review of the malaria program both in the field and in headquarters by a joint Government of Pakistan (GOP)/WHO/A.I.D. malaria specialist team. Despite increasing levels of insecticide resistance, procurement problems and sharply increasing insecticide costs, malaria was effectively controlled, its incidence declining to 0.04% of the population in 1980 by means of residual insecticide spraying of rural dwellings; surveillance activities; and use of antimalaria drugs. Urban malaria control activities were initiated but require much more development. Other outputs included the following: (1) Several studies were carried out on insect susceptibility, vector investigations in problem areas, and the impact of malaria on economic development. The Central Research Unit remains to be established. (2) In-service and regular training courses were held in provinces and at the National Training Center. The Lahore Malaria Training Center continues to require additional support. (3) Mass media was used to elicit public involvement in the malaria program and to obtain cooperation in carrying out spraying and surveillance activities, but much more should be done in this area. (4) Antimalaria measures in urban areas were carried out through establishment of urban malaria cells and provision of funds for insecticides and equipment to municipalities. (5) Although malaria activities were administratively integrated into the Basic Health Services project in all four provinces, functional integration was completed only in Punjab. The project has taught that continued cooperation is needed among governmental offices concerned with development activities, e.g., irrigation, public works, and agriculture, to avoid creating malariogenic conditions. A final evaluation of the project (PD-AAI-301-A1) is attached.