Report of evaluation of regional public health training project (625-11-540-510), Central West Africa, July 26-August 27, 1976

APPROXIMATELY 75 HEALTH COMMITTEES WERE ORGANIZED IN RURAL VILLAGES ALTHOUGH PROBABLY LESS THAN HALF OF THESE REMAIN ACTIVE. A SUBSTANTIAL NUMBER OF NURSES, DISPENSARY ATTENDANTS, ITINERANT HEALTH WORKERS AND OTHER LOW-AND-MID-LEVEL HEALTH WORKERS WERE PROVIDED SPECIAL REFRESHER TRAINING IN HEALTH EDUCATION. DEMONSTRATION HEALTH CENTER STAFF EDUCATION PROGRAMS WERE INITIATED IN CHAD WITH APPARENT CONTINUITY, AND IN THE CENTRAL AFRICAN REPUBLIC ONLY TO BE DISCONTINUED. ALTHOUGH SIGNIFICANT TIME, EFFORT AND MONEY WENT INTO THE PRODUCTION OF HEALTH EDUCATION MATERIALS, LITTLE OF LASTING VALUE WAS DEVELOPED. OCEAC'S (ORGANIZATION FOR THE CONTROL OF ENDEMIC DISEASES IN CENTRAL AFRICA) PARTICIPATION IN THE PROJECT FROM THE BEGINNING HAS BEEN A MATTER OF CONVENIENCE DESIGNED TO MEET AID'S REQUIREMENTS. PERHAPS ONE OF THE MOST SUCCESSFUL, ALTHOUGH INTANGIBLE ASPECTS OF THE PROJECT, HAS BEEN THE INTRODUCTION OF HEALTH EDUCATION CONCEPTS TO BOTH THE TOP POLICY AND MANAGEMENT LEVEL OF MINISTRIES OF HEALTH AND TO OPERATIONAL-LEVEL HEALTH WORKERS IN HEALTH CENTERS AND DISPENSARIES. HOWEVER, WHETHER OR NOT HEALTH EDUCATION ACTIVITIES WILL CONTINUE AS A PART OF HEALTH SERVICES IS UNCERTAIN. IN SUMMARY, THE GREATEST VALUES OF THIS PROJECT LIE IN ITS INTRODUCTION OF THE HEALTH EDUCATION CONCEPT TO HEATLH WORKERS IN THREE COUNTRIES, THE TRAINING OF A SMALL GROUP OF NATIONAL COUNTERPARTS, AND, MOST OF ALL, IN THE NEGATIVE LESSONS FROM THE CONCEPTION, DEVELOPMENT, OPERATION, AND EVALUATION OF THIS PROJECT. THE THREE SIGNIFICANT PROJECT AREAS IN WHICH MISTAKES WERE MADE ARE: (1)THE CONCEPT OF HEALTH EDUCATION; (2)THE RELATIONSHIP AND UNDERSTANDINGS WITH THE HOST GOVERNMENT; AND (3)THE PROJECT ITSELF -- ITS DESIGN, OBJECTIVES, RESOURCES, OPERATION, AND EVALUATION.