Project assistance completion report : Panay unified services for health (PUSH) project (492-0312)

The project achieved (or exceeded) about 97% of its specific targets. The incidence of tuberculosis and gastrointestinal infections was reduced by 65% and 82%, respectively, vs. targets of 25%. Second-degree malnutrition decreased 96%, exceeding a target of 70%, while the crude birth rate was reduced to 21 (per 1,000 married women 15-49 years), surpassing a planned rate of 24. On the negative side, third-degree malnutrition decreased by only 14% (vs. a targeted of 40%), and there was an apparant rise in infant mortality of 10-15% (although this figure is possibly inaccurate). Several lessons were learned. (1) Clear identification of project outputs, intermediate and impact targets, and the quantification and operational definition of these targets made project monitoring more effective by providing project management with necessary direction in project implementation. (2) Supportive involvement of regional and provincial leaders also contributed to project success, and has led to the continued operation of the project even after A.I.D. funding ceased. (3) The project made a strong case for the use of community health workers. The CHW's role increased over time as communities came to appreciate and benefit from their services.