Midterm evaluation report : partners for health and child survival project -- Pearl S. Buck International

Interim evaluation covers the period 9/99-11/01. The Pearl S. Buck Foundation is the implementing agency. The basic groundwork for the project has been established and activities have commenced in capacity building, community mobilization, and testing of innovations. Critical intervention models such as Hearth, Mother Support Groups (MSG), Weighing Posts (WP), and the Basic Child Learning Package (BCLP) have been tested. Necessary training has been conducted. The project deserves commendation for building on existing structures and taking a deliberate policy not to replicate or add new structures and protocols that can result in overloading the local health system. The more innovative interventions such as Hearth Nutrition Model and WPs have attempted to adjust to the local context and paid attention to local requirements and limitations. Overall, training activities have established service delivery competencies in all three intervention areas: nutrition and breastfeeding; maternal care, and child spacing. The project has achieved notable progress in establishing weighing posts in a majority of the project barangays. Health action planning has been conducted, encouraging the ownership of activities among the community. Examination of 2001 knowledge, practices, coverage (KPC) survey results show that breastfeeding and nutrition indicators compare well with midterm targets set by the detailed implementation plan (DIP). Maternal care indicators did not fare as well, but child spacing indicators generally show positive results compared with their midterm targets. Using Ministry of Health Field Health Surveillance Information System (FHSIS) data, the number of new family planning acceptors for all methods have significantly increased in project areas. On the down side, there is a need to strengthen the project"s monitoring and evaluation component, documentation is inadequate, and there is a lack of operations research studies, as well as a poor analysis of these studies. There has been no coordinated exit strategy, although the Advisory Board is in place to assist with this. In terms of capability-building, with the participation of local officials and service providers in the training program, there was a discernible increase in the sense of ownership in project activities. In the area of service delivery, health providers, particularly midwives and barangay health workers (BHWs), were trained in counseling on breastfeeding, nutrition, and family planning. For facility upgrading, health centers were provided with additional equipment. As a capacity-building as well as a sustainability strategy, the multi-sectoral advisory board that had been set up to oversee the implementation of the projects has formally linked the barangays to a potential pool of local consultants, many of whom are capable of providing TA to the project. The project"s capacity-building strategies strengthen the prospect for sustainability, as managerial and technical skills have been emphasized in many of the early training workshops. Equipping health centers and service providers with information, education, and communication (IEC) and medical equipment also help ensures the facilities" readiness to provide necessary health services. Financial sustainability is a more difficult issue.