OUHAM PROVINCE RURAL HEALTH

THIS SPECIAL EVALUATION COVERS THE PERIOD 12/79-2/80 AND WAS CONDUCTED BY AN EVALUATION TEAM THROUGH ONSITE VISITS, REVIEW OF PROJECT DOCUMENTS, AND INTERVIEWS WITH PROJECT PERSONNEL. PROVOKED BY THE CHIEF OF STATE OF GOCAR, THE USG DENIED ASSIGNMENT OF AN AID OFFICER TO BANGUI IN 9/77, AND THEN TERMINATED THE PROJECT IN 9/79. SEVERAL PERSONNEL, LOGISTICAL, AND FINANCIAL PROBLEMS WERE SO SEVERE THAT SUCCESSFUL IMPLEMENTATION WAS IMPOSSIBLE, WHICH PROMPTED THE EVALUATION TEAM TO RECOMMEND THAT THIS PROJECT AS DESIGNED NOT BE REINSTATED. THE CHIEF OF PARTY ARRIVED SIX MONTHS AFTER THE PEACE CORPS VOLUNTEERS (PCV'S) AND STAYED ONLY FOUR MONTHS; DISPENSARY CONSTRUCTION WAS DELAYED DUE TO TRANSPORTATION PROBLEMS; A CHRONIC FUEL SHORTAGE DISABLED THE MOBILITY REQUIRED FOR HEALTH SERVICE DELIVERY; FUNDING WAS DELAYED FOR LACK OF PROJECT MANAGEMENT IN CAR; LONG- AND SHORT-TERM TRAINING WAS, RESPECTIVELY, NON-EXISTENT AND NON-QUANTIFIABLE; AND A FULL COMPLEMENT OF PROJECT PERSONNEL WAS NEVER REALIZED. MANAGEMENT DIFFERENCES EXISTED BETWEEN USAID/YAOUNDE AND PCV'S/BANGUI, RESULTING IN LIMITED OUTPUT ACHIEVEMENT. OTHER CONFLICTS AROSE BETWEEN AID, PC, AND GOCAR PERSONNEL. PLANNED OUTPUTS WERE TO INCLUDE DEVELOPMENT OF HEALTH MANAGEMENT, HEALTH CARE, EDUCATION, SANITATION, AND VEHICLE MAINTENANCE SYSTEMS. ALTHOUGH SOME ACTIVITIES WERE INITIATED IN THESE AREAS, NO SUBSTANTIAL PROGRESS WAS MADE. GOCAR PROJECT MANAGEMENT CAME UNDER THE FRENCH DIRECTION DE SANTE RURALE ET GRANDE ENDEMIES. THUS, IMPROVEMENT OF HEALTH MANAGEMENT CAPACITIES BY CENTRAL AFRICANS WAS NOT POSSIBLE. RECOMMENDATIONS INCLUDE: THAT GOODS FINANCED BY AID BE TURNED OVER TO THE MINISTRY OF HEALTH; FUTURE AID/PC EFFORTS IN CAR INCLUDE MUTUALLY AGREED-UPON JOB DESCRIPTIONS FOR PCV'S AND THEIR ASSURANCE TO WORK UNDER AID-DESIGNATED SUPERVISION; POSITIVE MEASURES BE TAKEN IN ADVANCE TO SOLVE FUEL PROBLEMS; AND THAT USAID NOT DESIGN HEALTH PROJECTS WHERE EXPATRIATE MANAGEMENT EXISTS.