Midterm evaluation : AFRICARE child survival project, Ganzourgou Province, Burkina Faso

The evaluation team, which included Ministry of Health (MOH) representatives, the Africare Child Survival Coordinator from Washington D.C., and a child survival consultant, visited villages, meet with project staff and government officials, and conducted group and individual interviews, observed activities, and reviewed documents. The main project accomplishments are 205 well trained neighborhood "counselors" who are functioning effectively at the household level in oral rehydration interventions and vaccination mobilization. Each woman is supporting approximately 15 households, providing education and rehydration support when children in her neighborhood get diarrhea. The project has also achieved a very high participation rate for growth monitoring, but this is attributable to the efforts of health promoters hired and trained by the project. Lastly, the project has trained 23 health center nurses and midwives in oral rehydration and nutrition interventions; nurses in the impact area health centers report changing their practice in the treatment of diarrhea as a result of the training and their subsequent experience. While it is too early to truly determine the success of the model, training neighborhood women to actually carry out the interventions appears very promising, both in terms of achieving behavioral change at the household level, and in terms of being able to carry out the activities on their own with minimal support. The messages have been kept very simple and a lot of up front training time has been invested in order to make this possible. Primary recommendations focus on the need to increase the project"s interface with the MOH. While the emphasis so far has been on the establishment and training of counselors, the project now needs to work more actively and closely with all levels of the provincial health structure in order to assure maximum impact as well as to achieve sustainability. The project also needs to begin developing village-level structures to support and maintain the health activities of the counselors and village health teams. The project needs to expand the view of its work to one of more integrated development; this is particularly important with Africare"s beginning a new water project in the area. Lastly, the nutrition program should begin to shift its emphasis away from the weighing activity to defining and emphasizing simple messages about food intake that the counselors could carry out at the household level. (Author abstract)