SOUTHERN SUDAN PRIMARY HEALTH CARE PROJECT

Evaluation covers the period 10/1/78-2/28/80 and is based on site visits; interviews with beneficiaries, Ministry of Health and other agency personnel; and reviews of donor reports and financial statements. Project implementation was severely impeded by poor transportation, communication, and supply systems. The closing of the Ugandan border for 6 months caused acute supply difficulties and delays in construction. Due to lack of materials to construct staff housing, two of four staff positions went unfilled. In spite of this, it was necessary to appoint a full-time project manager in 1/80 since the medical training officer was unable to effectively supervise the project in addition to his other duties. Technical assistance from the African Medical Research Foundation enabled the training component to be the most successful, building one community health worker (CHW) training school and dispensary and beginning another, albeit 6 months behind schedule. Construction of 10 PHC units awaits the completion of the two training schools. One week refresher training courses were held for 40 CHW"s, 30 medical assistants, 25 nurses, and 27 sanitary overseers. A CHW training manual was revised and tested, but participant training was postponed for a year. Under the information/evaluation component, two of four targeted baseline studies were completed, and forms for monthly reports and evaluations of CHW"s were developed and tested. Under the logistics/supply system component, the reporting and accountability system for drugs was upgraded, and the PHC program"s drug list was revised. However, a lack of foreign exchange caused a shortage in PHC drugs and prevented CHW"s from providing curative care. One lesson learned was the need for a full-time project manager, especially in view of the difficulty of implementation in remote areas. Attachments contain recommendations for additional training, construction, replacement of staff dropped by other project donors, and final project evaluation.