Project paper : Egypt : urban health delivery system

The project will upgrade service delivery at the primary and secondary levels - Maternal/Child Health Clinics (MCHC"s) and General Urban Health Centers (GUHC"s). The project will: (1) develop an MOH institutional capability to perform health sector assessments; (2) establish a pyramidal health care delivery and referral system involving local MCHC"s, GUHC"s, and a specialty pediatric hospital; (3) establish a center for social and preventive medicine within CU"s Pediatric Hospital; (4) provide training to health personnel; (5) increase community participation, motivation, and health services outreach; and (6) conduct feasibility studies and introduce low-cost innovations to improve health service delivery. Amendment No. 1 of 8/30/79 authorizes (without additional funding) the renovation and equipping of 12 additional neighborhood MCHC"S in Cairo"s North and East zones, bringing the project total to 22. USAID/E plans to expand MCHC unit renovation to the entire metropolitan Cairo area during the life of the project. Funding implications of this further expansion will be reviewed following the first year"s experience. An Egyptian firm will perform architectural and engineering (A&E) services. Attached is a copy of the MOH"s initial A&E survey of the 12 new units. (PD-AAC-270-G1) Amendment No. 2 of 6/25/81 extends project to 1/30/86 and adds two new components - expansion of the project to Alexandria and innovative activities to extend health care beyond the MOH system into the private and semiprivate sectors. A staffed coordination office will be established in Alexandria and services there improved; MCHC"s will be renovated/reequipped (no new construction is planned); educational materials from the central project will be provided; and interventions from the Cairo pilot projects adapted or replicated as appropriate. Possible innovative activities include an information system to help expand coverage by the Health Insurance Organization; volunteer home visitor programs; youth involvement in family planning and health education; and an improved referral system between medical and social service providers. A special unit will handle administrative aspects of these subprojects. (PD-AAI-055) Amendment No. 3 of 8/21/84 provides funds to cover increased construction costs (resulting from inflation and from a decision to build to U.S. rather than Egyptian construction standards) and extends the project through 7/87 to allow sufficient time for construction. (PD-AAQ-658)