RURAL COMMUNITY HEALTH

UNDER GRANT, AID WILL FIELD TECHNICAL ASSISTANCE TEAM COMPOSED ON PHYSICIAN, NON-PHYSICIAN PRACTITIONER, AND HEALTH SERVICES ADMINISTRATOR. WORKING WITH COUNTERPARTS, TEAM WILL DESIGN AND ORGANIZE SHORT TRAINING COURSES TO UPGRADE EXISTING PARAMEDICAL PERSONNEL; PROVIDE TRAINING TO SUPERVISORS OF PRIMARY CARE WORKERS AND COMMUNITY LEADERS; ORGANIZE AND IMPLEMENT AN EXPANDED OUTREACH PROGRAM; UPGRADE MANAGEMENT OF HEALTH SYSTEM AND MAINTENANCE OF PATIENT RECORDS; DESIGN AND MANAGE A CLINICAL AND PUBLIC HEALTH FIELD TRAINING PROGRAM FOR INTERNS ASSIGNED TO THE TWO PROVINCES; DESIGN AND TEST INNOVATIVE APPROACHES TO HEALTH SERVICES DELIVERY; AND DESIGN AN EVALUATION COVERING BOTH TECHNICAL AND CAPITAL COMPONENTS OF PROJECT. GRANT WILL ALSO FUND LIMITED PARTICIPANT TRAINING, PROJECT SUPPORT EQUIPMENT, AND LOCAL COSTS FOR TRAINING AND FIELD TESTS. LOAN COMPONENT WILL FINANCE THE RENOVATION AND EQUIPPING OF 8TYPE A, 1 TYPE B, AND 10TYPE C HEALTH FACILITIES, AND THE CONSTRUCTION OF 6 TYPE A, 1 TYPE B, AND 15 TYPE C FACILITIES. TYPE C FACILITIES PROVIDE AMBULATORY SERVICES, INCLUDING HEALTH INFORMATION SERVICES, MINOR BURN AND TRAUMA TREATMENT, AND DISTRIBUTION OF ORAL MEDICATIONS, DRESSINGS, INJECTIONS, AND BIRTH CONTROL SUPPLIES, TO POPULATIONS OF 2000 TO 5000. TYPE B CENTERS SERVE POPULATIONS OF 5000-10,000, AND PROVIDE MATERNITY AND MINIMAL LABORATORY SERVICES IN ADDITION TO TYPE C SERVICES. TYPE C CENTERS SERVE POPULATIONS IN EXCESS OF 10,000, AND ARE STAFFED BY A PHYSICIAN AND A MIDWIFE. CENTERS PROVIDE BASIC INTEGRATED PREVENTIVE AND CURATIVE SERVICES AND OFFER MATERNITY CARE AND IN-PATIENT INFIRMERY SERVICES. PRIMARY BENEFICIARIES OF PROJECT ARE THE RURAL POOR. AMENDMENT NUMBER ONE WILL PROVIDE ADDITIONAL A.I.D. GRANT AND LOAN FUNDING TO INCREASE THE GEOGRAPHICAL SCOPE OF THE PROJECT TO INCLUDE THE KASSERINE GOVERNORATE AND THE THREE NORTHERN-MOST DELEGATIONS OF THE GAFSA GOVERNORATE. THE TERMS OF SERVICE FOR THE U.S. NON-PHYSICIAN PRACTITIONER AND THE MANAGEMENT SPECIALIST WILL BE EXTENDED AND TECHNICAL ASSISTANCE SERVICES FOR PARAMEDICAL AND INTERN TRAINING WILL BE EXTENDED. A.I.D. WILL ALSO PROVIDE FOR LONG- AND SHORT-TERM TRAINING IN THE UNITED STATES AND THIRD COUNTRIES. AN ADDITIONAL 30 HEALTH CENTERS WILL BE BUILT AND TEN FACILITIES WILL BE RENOVATED.