Report : final evaluation of the USAID anti-malaria project, July 5-27, 1983, Bangkok, Thailand

Final technical evaluation covers the period 8/79-7/83 and is based on site visits and interviews with USAID/T and RTG officials and with village volunteers. Although many project targets have been met, malaria remains a major health problem in Thailand due to internal population movements, drug resistant parasites, and behavioral changes in vector populations. Malaria spraying has been less complete than planned (67.6% of target in 1982), largely because of household refusals. However, public acceptance has been gradually increasing due mainly to an extensive health education campaign. Showing of movies has in particular been correlated with increased acceptance of spraying, while posters and cassette tapes have also been well received. The training capacity of the National Anti-Malaria Program has markedly improved. Training has been provided to over 22,000 village volunteers and to 580 malaria clinic workers, both through pre-service and refresher courses, as well as to other public health personnel. U.S. academic training and observation tours for supervisory personnel have been somewhat less successful, due variously to a lack of candidates, competing WHO fellowships, and internal delays. The Malaria Training Center at Phraphutthabat has undergone major improvements and expansion, doubling its capacity (to 58 students), and malaria training manuals and curricula have been revised. Major capital improvements have also been made, with positive impacts, at 3 research facilities, 3 unit offices, and a second training center. Eight applied research projects have been initiated (4 remain in progress) and several field trials conducted to develop future malaria control strategies. Although the hypotheses tested in the 4 completed studies were directly relevant to malaria control, results have had only minimal impact on the project due to research design and control problems, including lack of direct supervision, the shortness of the study period, and a failure to follow protocol and analyze data completely. Detailed recommendations address needed technical and operational improvements in the RTG's anti-malaria program.