Project evaluation of the CARE/Congo nutrition education project

Special evaluation covers the year 1985 (the first of the project"s 3 years and the year to which A.I.D. funding was limited) and is based on document review, site visits, and interviews with project and Government of Congo (GOC) personnel. The training and materials development components are ahead of schedule and have expanded into new areas. The project has established a broad base of well-trained health workers, training 315 animateurs in malnutrition and 415 health agents in the use of growth charts. It has also produced teaching manuals and curricula, posters, flipcharts, radio programs, songs, and an updated growth chart; ordered maternal/child health clinic supplies; and, due to the inadequacy of the supervisors chosen during Phase I (1980-83), begun training the supervisors of the animateurs. and nutritional status surveys have not been performed, but a scientifically rigorous study by an outside research team is planned for 1986. It will be used for long-term assessment and a as a model for evaluation. Despite much collaboration with GOC institutions, the project remains a free-standing organization with no significant sustaining support expect through the CARE project staff. It is seeking to integrate its nutritional messages and programs into the curricula of schools for health workers and eventually into the existing health infrastructure. This integration is essential for the long-term sustainability of the project, which as it is is much too costly and lacks adequate top-level GOC support. Three lessons were learned. (1) To be accepted, health messages must be specifically targeted, clear, limited in number, and delivered through several media. They must also be discussed and debated with the target audience so that underlying misconceptions and resistance may be aired. Educational materials must be extensively field-tested and revised. (2) Supervisors can be effective only if they have access to their employees (animateurs), have authority over them, and are trained in the work that the employees perform. (3) Training programs requiring significant travel by either trainers or trainees are not cost-effective. A structure is needed to enable local supervisors to train animateurs at their place of work. There should be minimal travel and supervision by central staff.