Program for immediate improvement of primary health care

The program grant will finance U.S. imports of health-related goods and services for the public or private sector. Local currency will help finance short-term cost of restructuring the PHC system and will be managed by the Ministry of Health. The GOC program will improve the PHC system in four areas. (1) To expand PHC delivery to underserved areas and strengthen administration and supervision, the program will reconstitute PHC Directorates in 104 rural and 25 urban priority health service areas, and train them and other PHC personnel; conclude agreements with the mayors of these health areas, specifying PHC activities and supervisory responsibilities; establish resource allocation and management information systems; and promote PHC worker morale through motivational training and, possibly, establishment of a career civil service. (2) The technical problemsolving capacity of the priority PHC areas will be improved by the provision of basic diagnostic equipment and laboratories and the training of personnel in their use. (3) To improve access to PHC services, the program will work more closely with NGO"s, help NGO"s initiate pilot programs in priority urban areas; establish thirteen 24-hour emergency services in low-income urban areas; and extend the hours of 38 PHC centers. (4) Finally, the GOC will support several innovative programs, including community-based mental health centers; extension of a university-based program for training family health practitioners to the PHC system; a model for delivering PHC services to the elderly; and establishment of community health councils and community support systems in at least 80% of priority communities. Other donors to the GOC program include the World Bank, the Inter-American Development Bank, and the Governments of Germany, France, Spain, and Italy. Supporting TA will be provided under project 5130351.