Northern primary health care

PES covers the period 10/79-9/80 and is based on document review and interviews with host country and contractor personnel. Absence of a full-time USAID/S project manager (for 8 months) and of a Chief of Party (for 5 months), together with the difficulty of travel in the Sudan, has made project completion by the 6/30/82 target date doubtful and has led to a narrowing of the project"s scope (to the northern region, especially to Kordofan and to provinces with nomadic populations), and reductions in output targets, and revised end-of-project indicators. It is premature in most cases to judge progress toward the latter. More particularly, planned training of community health workers (CHW"s), MOH counterparts, community physicians, and provincial health personnel has had to be replanned, and none of 35 targeted PHC facilities have been built, as this target has been reoriented toward the building of 20 Phase I dispensaries. Long-term drug supplies have not been available to PHC facilities (where storage facilities have been inadequate) and gasoline for project vehicles - maintenance of which has posed a problem - has been in short supply. Also, equipping and supervision of CHW"s have been inadequate. Positive achievements have included, inter alia, health needs assessments in the southern region; revised National Data System health care forms; use of nurses and CHW"s to register vital statistics in the face of scarce MOH and Ministry of National Planning respources; and proposed measures to increase the movement of medical supplies from Port Sudan to Khartoum. If the program to provide CHW"s with continuing medical education is a success, the MOH will seek donor help to institutionalize the program. terrain of each province when ordering vehicles and the use to which the vehicles will be put. An outstanding project issue is whether the recently-authorized Rural Health Project is in fact the follow-on anticipated by the MOH at the time the present project was assigned. Twenty recommendations are listed.