REPORT ON A MID-TERM EVALUATION OF BASIC HEALTH MANAGEMENT DEVELOPMENT IN NINE CARIBBEAN COUNTRIES

This contracted special evaluation covers the project"s first 18 months up to 11/80 and is based on a review of documents, site visits, and interviews with project personnel and beneficiaries. Interpersonal skills training, the first of four training efforts, benefitted 819 upper, middle, and lower level managers in Barbados, St. Lucia, St. Vincent, Belize, and Antigua. However, no orgranizational impact assessment can be made yet. Unlike other training and assistance efforts, team building training was wisely linked to the Model District Health Teams (MDHT) program. Initial responses to training and MDHT have been positive. Management information system needs were assessed for participating nations. A materials resource center was established on Antigua; hurricanes have delayed those of other nations. CARICOM"s dedicated staff has upgraded its ability to implement regional programs. It is recommended that training in program design and implementation for top level managers be given in conjunction with the Caribbean Development Bank, which is willing to expand into this area. Shortfalls include hasty project planning and implementation, as seen in the budget, which omitted major special activity and contractor costs, and in the training program, which began without adequate materials. Further, training has not been standardized and the first and third training efforts duplicate each other. CARICOM itself should implement the third effort, avoiding duplication by stressing management skills, tools, and techniques. Technical assistance goals in organizational analysis, health planning, and information systems cannot be met in the time allotted. Host countries are dissatisfied with assistance in the first two areas. CARICOM"s close monitoring of the finances of the training contractor, Westinghouse Health Systems, has led to a critical lack of communication between the two. Finally, little has been done to create an ongoing skills development capacity in participating institutions.