Midterm evaluation of the primary health care operations research project (PRICOR)

Mid-term evaluation covers the period 9/81-5/84 and is based on document review and interviews with project, AID/W, and Project Advisory Committee personnel. Project staff have developed an innovative, highly focused OR methodology which uses models borrowed from agriculture and other fields (which have rarely been used in PHC) to screen alternative interventions. If the methodology is shown to work well under field conditions, it is indubitably a major advance for PHC. The major activity thus far, has been review of some 400 OR proposals, 40 of which (in 30 countries) have been funded, vs. a target of 28. The studies focus on four areas - community support (health workers, financing, and organization) and commodity management. Proposal solicitation and review have been performed most competently and have provided access to a wide variety of PHC programs and researchers that would otherwise have remained unknown to A.I.D. Nevertheless, there is concern that the review mechanism (which does not include review by persons familiar with a proposal's local context), combined with a strictly defined research approach, limits the project's ability to respond to promising research opportunities. While other activities are behind schedule, it is expected that all will be developed in the second phase of the project, particularly the technical monitoring and comparative analyses of country studies, methods papers, and other information dissemination activities. The project has been extremely well managed, with staff showing great experience and imagination for streamlining operations to save time and costs. Nonetheless, activities such as methods papers and technical monitoring have proven more complex than had been thought and it is clear the staff are overworked. It is recommended that the project be extended up to a year with the same contractor; 2 additional staff should be hired and priority during the remainder of the project should be given to analyses and dissemination of generalizable findings. Recommendations are also made regarding a proposed 5-year follow-up project.