RURAL HEALTH SUPPORT

The project, to be implemented by the African Medical and Research Foundation (AMREF) in the south and a contractor in the north, will improve PHC facilities, personnel, and management. The project will construct and equip 6 training facilities, and will provide in-country or participant training, emphasizing preventive health, to 4,863 community health workers (CHW"s) and village midwives (VMW"s). Continuing education programs will be provided. Seven radio programs will be produced and broadcast, including programs on preventive health for village audiences in two southern provinces and programs to teach CHW"s about health, sanitation, and child care. Six dispensaries in the north and six in the south, providing simple preventive/curative care, as well as maternal/child health (MCH) care, will be constructed and equipped; each will serve three satellite PHC Units (PHCU"s). In addition, building materials will be provided to speed self-help construction of PHCU"s. In connection with a UNFPA program to integrate MCH and PHC, 4,000 rural and urban CHW"s, VMW"s, and traditional birth attendants will be trained in MCH/family planning (FP). Two VMW training schools will be constructed and given training materials. The health cadre will be equipped with drugs and midwifery kits. To improve planning and management at the central, regional, and provincial levels, regional Ministry of Health (RMOH) personnel will develop PHC planning systems, train managers, and develop budgets. RMOH personnel in the south will also be helped with operations research design and personnel and facility surveys. Administrators from all MOH sectors will receive training and field work in information/statistics, planning, management, budgeting, and auditing. Other training will include: management training in Kenya for 2 senior southern personnel; seminars on logistics/supply systems, budgeting, and personnel management; courses in data collection/analysis and management information system use; and training of pharmacists. To upgrade logistics/supply systems, 8 trucks will be provided and 12 warehouses constructed and equipped. Amendment of 1984 adds/increases activities in data collection, sanitation, pilot efforts to reduce child mortality, oral rehydration therapy (ORT), and drug procurement/distribution. (This paragraph from information in PD-BBM-738.) Amendment of 4/86 reduces funding for the south, due to security concerns, and increases funding for the north. In the south, activities will be restricted to Equatoria Region, and will emphasize the institutionalization of MCH/FP services in the PHC system. In the north, emphasis will be on linking training and management with service delivery, particularly in the areas of immunization and ORT. (PD-BBU-783) Amendment of 7/88 reinstates activities in the south that were curtailed under Amendment No. 2 and extends PACD to 8/90. (PD-BBM-738) Grant of 10/30/88 to AMREF will enable AMREF to continue to assist the MOH in providing health services to residents and displaced persons on the outskirts of Juba during the extension period, in what will be termed Phase II of the project. Phase II will basically be a continuation of Phase I, though with added emphasis on: (1) community participation, development, and self- help; (2) water and sanitation; and (c) increasing data collection and reporting by health workers. (PD-BCB-297)