MEMORANDUM AUDIT REPORT, PAN AMERICAN HEALTH ORGANIZATION

Evaluation covers the period 6/30/76-8/31/80 and is based on an audit review of files and interviews with project participants. After its design was unsuccessfully modified, the project was dropped after 5 years. Since A.I.D. had knowledge of the project"s shortfalls, it is felt that the Agency was remiss in conducting only two early evaluations and in not using the services of the Mission or ROCAP to review the project"s progress. A baseline nutritional study, including a census, was conducted by the Institute for Nutrition of Central America and Panama (INCAP) on 12 plantations, each consisting of 350-1,600 inhabitants. A simplified health program emphasizing preventive medicine was begun, a training manual was produced, and rural health promoters were trained. The people visited project health posts often, and due to the program, infant mortality rates dropped from 160 to 90. Under a sanitation program, potable water supplies were upgraded and latrines were installed in 10% of the houses. The Ministry of Health and plantation owners supplied building supplies and labor for the latrines. Only five of the plantations had potable water, however, and inhabitants showed a preference for large volumes of water instead of a small supply of potable water. Food supplements including opaque-2 corn and beans were sold to the residents, but the results of the intervention were never measured. The plantations still owe INCAP $20,000 for these commodities. INCAP should collect this and refund it to A.I.D. (INCAP would like to use the funds to improve the plantations" water systems and to expand the latrine program.) INCAP"s accounting records were in order, with cost overrun absorbed by INCAP. There was some dispute, however, over A.I.D."s verbal approval of salaries for individuals not identified in the contract. Questions also arose regarding the proper allocation of some of ROCAP"s indirect costs. The contract officer should recover any costs not eligible under the contract.