Report of a process evaluation : Bicol integrated health, nutrition and population project

Special evaluation covers the period 8/79-12/82 and is based on document review, site visits, and interviews with project personnel and beneficiaries. Performance has been mixed. Despite a need to strengthen certain areas (especially community organization, communications skills, and communicable disease control), the targeted 400 Barangay Health Aides (BHA's) have been well trained and supervised, performed adequately, and received good support from all levels of local government and from the communities they serve. On the debit side, the project has failed to determine whether it intends BHA's to provide health services or merely health education, and local government officials will have difficulty meeting the need - caused by a 1/83 unilateral decision by the GOP's Project Management Office (PMO) - to pay half the BHA's stipends. The PMO has also failed to staff the project adequately; in fact, since all of its key members are regular Ministry of Health employees, it is questionable whether the PMO exists in more than name. The lack of PMO personnel, along with the slow release of funds by the GOP's Office of Budget Management, has caused the environmental sanitation infrastructure component to fall seriously behind schedule. Only 10,200 household toilets (vs. a targeted 32,000) have been installed, only 6 (of 400 targeted) community water facilities have been constructed, and none of the 400 targeted school toilets have been built. Planning to chlorinate water and to upgrade household water facilities is yet to begin. Also, the PMO has been supplying materials for barangay water systems on a grant basis rather than under the lending arrangement stipulated by the loan agreement. Mainly as a result of delays with this component, only 17% of A.I.D. funds have been disbursed with the project almost two-thirds complete. A 1-year extension will probably be necessary. Finally, there is little evidence that other line agencies are participating in this "integrated" project. Numerous recommendations are included.