Project assistance completion report : population dynamics project (no. 519-0210)

The project achieved or exceeded several of its targets. For example, a large mass media campaign was developed to promote FP services offered by public health agencies and the private sector Salvadoran Demographic Association (SDA), and some 4.4 million pieces of educational materials (vs. a target of 1.9 million) were prepared. All training targets were met, and in addition, Johns Hopkins University trained 3,190 Ministry of Agriculture field workers to promote FP in their communities. The project was also instrumental in the development of a new National Population Policy and it established an FP supply management system, trained paramedical personnel in maintenance of laparoscopic equipment, and equipped an Infertility Clinic (though at 90% of the planned level). Lessons learned are as follows. (1) Projects to build institutions and especially a capacity for coordinated planning require at least a 5-year time-frame. (2) Whenever possible, complicated bureaucratic structures (e.g., this project"s Special Administration and Training Unit) should be avoided. If they are required, substantial administrative and financial management assistance are essential. (3) In El Salvador, integrating FP with other health programs increases public acceptance, However, within the integrated health care system, FP requires special attention. (4) To improve service delivery, attention must be given to training local policymakers and decisionmakers to organize and prioritize services. (5) IEC programs must blend mass media and interpersonal communication; interpersonal campaigns require considerable time and energy. (6) Every effort should be made to strengthen the private sector, which has proven the more effective FP implementor in El Salvador. (7) The TA team should have offices inside the institution it is working with. (8) Whenever possible, each major institution should have a separate project. (9) Logistics are essential and should always receive a high degree of attention. USAID is funding follow-on FP assistance under project 5190308 for the public sector and 5190363 for SDA.