Management of rural health services

PES covers the period 8/78-11/79 and is primarily based on document review. Targets have largely been met. The MOH now has an effective National Health Planning Unit (NHPU) with full responsibility for health planning and budgeting. The NHPU has developed a primary health care (PHC) strategy for Ghana and has been effective in convincing the MOH to initiate such a program. As contract TA has ceased, however, it remains to be seen if participants (10 of the 13 participants have recently returned to Ghana) will be able to keep the unit operational. The fact that three of the returned participants are not working full-time in the NHPU is a matter of concern. The NHPU organized and conducted a preliminary training session early in 1979 for the nine District Health Management Teams (DHMT"s) responsible for implementing PHC as well as a follow-up session in Summer 1979, the latter attended by only one DHMT team due to the unstable political situation. NHPU staff have made numerous trips to the nine districts to help DHMT workers prepare to initiate PHC operations. The NHPU has also been actively involved in the actual prepararation of the annual MOH budget submission and has conducted three regional workshops on PHC budgeting, the last without contract assistance; it is hoped that NHPU influence will result in budget shifts, sorely needed if the PHC program is to succeed. In addition, the NHPU with help from advisors has prepared and published three training and reference guides to assist practicing health workers in health planning at all levels. Three guideline papers are also being prepared. The project"s management training subactivity, suspended since 12/76, will begin again in 12/79 with assignment of a full-time PASA employee, who will work closely with the NHPU. Action decisions are: distribute the final contractor report, a valuable case study, to all A.I.D. Missions; and prepare to undertake, in 7/80, an intensive evaluation of NHPU activities.