Project assistance completion report : [Togo] Family Health Center

Construction of the Center was delayed more than 2 years due to several factors including difficulties in finding an appropriate contractor, the decision to build the Center in the World Health Organization Regional Training Center compound (a different location than was originally planned), and the long negotiations with the Ministry of Health over the structure and function of the project. Construction was finally completed in 7/82. Minor changes were made and construction deficiencies were corrected during the next 2 years. Final payment was made to the construction contractors in 3/84. The Center was fully staffed with qualified training and administrative personnel, including three educational facilitators, (a nutritionist, a midwife, and a nurse), an administrative coordinator, and a technical coordinator. By 7/83 the Center was fully equipped, and training courses began in 10/83. Funding for training courses at the Center was provided through a separate grant, awarded to Family Planning International Assistance. In sum, the project successfully achieved its primary purpose of building the Togo Family Health Center, albeit 2 years later than planned. In his final inspection of the Center, the REDSO/WA chief engineer described the Center as "attractive, well coordinated to the existing buildings, and entirely appropriate in design. It will serve the purpose for which it was intended." The following lessons have been learned. The project design and proposed inputs were not clearly understood by both parties to the agreement at the beginning of the project. Issues pertaining to the use of the new facility were not clearly resolved before the project began, resulting in some confusion surrounding the Center's purpose. Construction plans were drafted before the facility's activities were theoretically designed. Agreements on the use of the physical facilities among USAID, the GOT, and WHO should have been more clearly shared between all parties. Disagreements on use and design factors significantly delayed construction. Inadequate time was allowed for discussion between USAID and the host country on the project purpose and goals. A substantial length of time was necessary even after the project agreement had been signed to reach consensus on a number of important issues, resulting in prolonged delays in project start-up. (Author abstract, modified)