Suez community personnel training project; evaluation report

Special evaluation covers the period 5/80-6/81 and is based on site document review and interviews with contractor, Boston University (BU), and A.I.D. personnel. The project"s major commitment of resources to train a handful of physicians may be extravagant given the depth of health care needs in Egypt. Moreover, the project faces a host of problems. SCU"s capacity to develop curriculum is growing, but only the first year curriculum is nearing completion. BU personnel have not yet inspected the six clinical training sites identified in Ismailia; construction is unlikely to be completed by 9/81. No sites have been found in Suez or Port Said. The proposed primary care group practice -- to supplement the incomes of the underpaid SCU medical faculty -- is of doubtful viability. Good progress has been made in refurbishing teaching, laboratory, and administrative facilities. Although staff development and continuing education are proceeding, short-term U.S. training has been of little value; non-faculty and junior faculty education has lagged; and initiation of long-term U.S. training appears unwise. BU has failed to strengthen SCU"s management ability (e.g., developing lines of authority and budget and records systems), and SCU"s need for centralization is antithetical to a decentralized project. Finally, the proposed Phase II is too vaguely conceived and will conclude 3 years before SCU"s first medical class is graduated. It is recommended that A.I.D and/or USAID/E: (1) condition continued support on enrollment of a class in 9/81; (2) complete Phase I, request from BU a proposal for Phase II, and consider a possible Phase III (lasting until 6/30/87); (3) continue funding curriculum design, continuing education, primary care, and health center development; (4) support training for non-physician health center personnel and in general health care; (5) not support group practices until the prototype has been tested; (6) strengthen BU"s management advisory capability; (7) demonstrate the effectiveness of existing clinical teaching sites before funding new sites; and (8) require submission of curricula prior to Phase II.