Swaziland health training project

Evaluation covers the period 9/79-5/81 and is based site visits and interviews with project staff. Regarding health manpower training and institutionalization, the Institute of Health Sciences (IHS) has been constructed and training has begun for health inspectors (HI) -- 8 of 15 proposed HI students have completed the first year -- and registered nurses (RN) -- 32 have graduated and been posted to rural areas. Curricula for HI training and for the first 2 years of RN training are complete; the curriculum for the remaining 2 years of RN training is being developed. The seven Swazi nursing faculty are/will be in training by 8/81. Health planning and administration have progressed more slowly. Four district administrative units were identified as part of efforts to decentralize health services, three of 4 health administrators have been posted, limited orientation and hospital organization training was provided, a health statistics/data collection system is functioning in two districts, and five of 10 targeted Swazi health technician counterparts have been chosen, but to date no district health plan has been devised, planning for Swazi counterpart training is absent, qualified university graduates are few, and efforts to establish a hospital administrative system are behind schedule. It is recommended that: (1) the number of Swazi health administrator counterparts be cut from eight to four; (2) the contracts of the two health administrators and the family nurse practitioner be extended 1 year to allow prepartion of procedural manuals, continue health planning, and oversee counterpart training; (3) an IHS student hostel be constructed in Sithobela; (4) the structure and content of the fourth-year RN curriculum be determined; (5) a long-range IHS faculty training plan and schedule be developed; (6) a vehicle be purchased for the health statistician; and (7) bi-monthly meetings of senior management staff and the contract team be organized in order to plan and implement remaining project activities. Above all, the project taught that health planning is a multidisciplinary task.