State of the art of delivering low cost health services in developing countries, a summaring study of 180 health projects

THE ELEVEN PARTS OF THIS REPORT DISCUSS TRAINING AND MANPOWER, MATERNAL AND CHILD HEALTH SERVICES, NUTRITION PROGRAMS, FAMILY PLANNING SERVICES, FACILITIES, PROJECT OUTREACH, LINKING HEALTH GOALS TO ECONOMIC AND SOCIAL SECTOR ACTIVITIES, ENVIRONMENTAL HEALTH, MEDICAL SERVICES, HEALTH EDUCATION AND PROMOTION, AND ADMINISTRATION. THE STUDY WAS BASED ON QUESTIONNAIRE RETURNS FROM 180 PROJECTS SERVING PRIMARILY RURAL POPULATIONS IN ASIA (75) AFRICA (56) LATIN AMERICA (44) AND THE NEAR EAST (5). FINDS THAT: FEWER THAN FOUR OUT OF TEN PROJECTS ARE ATTEMPTING TO IMPROVE ENVIRONMENTAL SANITATION. PROJECT GOALS TEND TO BE VAGUE, WITH FEW AND VARYING MEASURES OF PROGRESS. MORE THAN 90 PERCENT OF THE PROJECTS PROVIDE MCH SERVICES, HEALTH EDUCATION, MEDICAL TREATMENT AND NUTRITION SERVICES, BUT INTENSITIES VARY GREATLY. NEWLY ESTABLISHED PROJECTS SHOW MORE INTEREST IN NUTRITION, AND IN COMMUNITY INVOLVEMENT IN PLANNING AND EVALUATION. ADMINISTRATIVE PLANS AND PRACTICES ARE SKETCHY AND WEAK. MUCH EXPERIMENTATION IS OCCURRING WITH TRAINING OF NEW CATEGORIES OF HEALTH WORKERS. PROJECTS CONSIDER THEMSELVES MODELS FOR REPLICATION, BUT APPEAR TO LACK THE RESOURCES NECESSARY FOR DETAILED PLANNING AND EFFECTIVE EVALUATION. IN GENERAL, FIELD HEALTH WORKERS ARE NOT PART OF AN INFORMATIONAL NETWORK THAT WOULD ENABLE THEM TO STAY ABREAST OF EXPERIENCE AND DEVELOPMENTS ELSEWHERE.