Mid-term evaluation : PAHO/AID project no. 597-0007 -- malaria

The evaluation covers the period 3/85-2/88 and focuses on the malaria component, which aims to strengthen malaria programs and institutionalize a training and research program for vector-borne diseases. Malaria programs in the region have been strengthened through the establishment of effective training and education programs at various levels, and progress has been made in integrating malaria control with general health services. The project"s subregional focus has enhanced local problemsolving capacity, improved institutional communication and coordination, and taken advantage of economies of scale, while enhancing program continuity and momentum. The malaria effort complements several related bilateral and multilateral projects and has contributed to a high level of cooperation among funding and operating agencies. Despite these achievements, much remains to be accomplished. In addition to the current stress on technical topics, training in health planning, administration, and management continues to be a high priority, and steps should be taken to further integrate malaria activities and other health services. Subregional and national research activities have focused on key topics, but the subregional research is behind schedule and local research capacity is limited. While the project is attempting to enhance research capacity through postgraduate and other types of education, this is a slow process. One of the most important lessons learned is that substantive organizational changes (in this case from eradication to control and from a vertical to an integrated program) require years of training, TA, and other support activities to ensure a successful transition. Therefore, it is recommended that the component be extended beyond the 3/89 deadline. Reports on malaria activities in each of the participating countries - Belize, Guatemala, El Salvador, Honduras, Costa Rica, and Panama - are included in the evaluation.