Report on the midterm evaluation of the Tanzania school health project

Special evaluation covers the period 9/80-8/82 and is based on document review, site visits, and interviews with school, health, GOT, USAID/T, and AID/W personnel. Although progress is being made, objectives will not be met within the allotted time. Implementation has been delayed by 12-20 months due to insufficient contractor authority over procurement and construction, a cholera epidemic which diverted the energies of the project field coordinator, materials unavailability, and transportation problems. The project has also suffered from the absence of the GOT program director (receiving U.S.-graduate training), and a lack of clarity regarding the roles of expatriate advisors and central and regional GOT health and education personnel. Despite these problems, a rough draft of a school health handbook has been produced; one chapter is being pretested in schools and a teacher training curriculum based on the handbook is being prepared. A protocol for teachers to use in screening for and treating illnesses, as well as a school health course are also in draft form. Limited project orientation training has been provided to district health officers, school health coordinators, and head teachers, but planned teacher training is threatened by the GOT"s failure to program funds for transportation and per diems. U.S. graduate training is being provided to two health officials, but no training has been programmed for education officials. Procurement of school health kit supplies and development of a student health record system have also begun. Inputs have been provided to school farms, but it appears unlikely that the farms will be able to support planned school feeding programs; while 1-3 schools have begun school feeding, most still lack kitchen facilities and utensils. The schools" water supply and sanitation needs have been ascertained; some digging of wells and latrines has begun. Finally, collection of baseline data for use in future expansion of the program is underway. Support for project activities among teachers, local officials, and community members has been strong. It is recommended that the project be extended 2 years to 9/85 to allow completion of planned outputs; other recommendations concern training and project management.