MCH/FP II

Evaluation, conducted jointly by participating agencies, covers the period 2/76-6/80 and consists mainly of recommendations in key areas. Strategy recommendations include: MCH/FP and Ministry of Health (MOH) programs should be correlated to accelerate development and regionalization of health systems. MCH/FPP should be extended to rural areas using auxiliaries and local health agents. The Division of Family Hygiene (DFH) should review its use of mobile teams; develop with the Bureau of Nutrition a comprehensive approach regarding children; and provide more training to district and regional staff. Over the next 2 years, MCH/FPP should not be expanded. Instead, attention should be given to developing integrated approaches in specific areas. Management recommendations include: A model for training auxiliaries working in nonhospital settings should be pilot tested. Patient recordkeeping should be improved at the delivery level, fee collection procedures standardized, and in-service courses provided for auxiliaries. Operational recommendations include: The system for supervising auxiliaries, matrones, and health agents should be strengthened. Vehicle controls should be improved at all levels. As few drugs as possible should be distributed to health agents. Equipment inventories should be kept at all health installations. DFH should encourage institution of a public health studies program; promote safe water development programs and the use of IUD"s and sterilization; and upgrade matrones training and training guidelines. A detailed Government of Haiti (GOH)/USAID/H response to the above is included. Major points made are that evaluators overstressed DFH"s role, ignoring MOH"s central importance, and focused on myriad remedial activities instead of identifying key program constraints, namely: lack of adequate GOH resources; the need to improve delivery of supplies to remote areas; and need to coordinate DFH with other agencies and to develop a strategy to integrate DFH/MOH operations.