Project assistance completion report, USAID/Guatemala : community based integrated health and nutrition systems project no. 520-0251

The project was originally designed with many health activities and sub-activities, which made it very complex to implement. The administrative organization did not function well, as the government agency responsible (the Directorate General of Health Services) did not have the required personnel for efficient and timely execution of the program. In 1985, the project was modified to focus exclusively on the environmental sanitation component. However, several activities in primary health care were undertaken during the period 1980-1985. Achievements included: training of 1,590 rural health promoters and 922 midwives; retraining of 1,210 rural health promoters and 556 midwives; anthropometric measurements of more than 6,600 newborn babies and more than 433,000 children under age 5, leading to detection of 362 undernourished babies and 19,515 undernourished children; and food and vitamin distribution to 15,673 persons. Immunizations and oral rehydration were carried out as well. In the environmental sanitation component, construction of water systems faced numerous problems, including a scarcity of counterpart funds, untimely disbursement of funds, and high turnover of construction engineers. Nonetheless, construction targets were met, with systems completed in 302 communities and in progress in 25 more. Water committees are in place in all of these communities. The project also constructed more than 29,000 latrines and provided training to 782 persons in water system maintenance and organization. In addition to meeting construction targets, the project also left an organized unit within the Government of Guatemala for future water supply and sanitation projects.