SMALL-SCALE COMMUNITY REHABILITATION - HEALTH

The project will be administered by the Ministry of Health and the Ministry of Finance. The physical structures of these rural health clinics range from simple two and three room structures of locally fired brick to a more elaborate model (about 45 by 20 ft) with treatment room, waiting room, storage room, office, labor ward, and pre-delivery waiting area. Most clinics have simple housing located in the same compound for the staff, and washing and toilet facilities are located adjacent to the clinic. Some clinics, located in areas requiring greater security for nurses, have attached housing. Roofs are almost all of asbestos sheeting. Windows are of a single sized, locally manufactured steel frame unit. Construction has been done and repairs will be made by local craftsmen. The following commodities will be provided for the clinics to be rehabilitated: construction materials, furnishings (beds, chairs, tables, cupboards, and bedding material), equipment (bowls, stands, trays, scales, and medical instruments), laboratory supplies, a small refrigerator for storing vaccines, and a three-month initial supply of medicines. In order to simplify procurement procedures, eliminate non-essential A.I.D. monitoring of procurement, and allow use of existing central supplies which will be available without undue delay, it is recommended that the imported shelf item limitation be increased for this project and that a source and origin waiver from code 000 to code 935 be issued covering all drugs, medical supplies, furnishings and equipment. Five local building supervisors (one for each province) will be hired to supervise reconstruction. Part of the cost of rehabilitating the clinics will be provided by the GOZ or by other financing secured by the GOZ. If this funding cannot be obtained, a lesser number of clinics will be rehabilitated. Once the rehabilitation is completed, the Ministry of Health will be responsible for providing the necessary clinic staff.