Technical evaluation of USAID CCH - Chagas' disease control project -- Bolivia -- August 1992

Chagas' disease is endemic and widespread in Bolivia and represents a critical national public health problem. A national program must aim for sustainable disease control through community-based activities for house and peridomicilary improvement, health education and judicious use of insecticides. Other components of a national program are a safe blood supply to eliminate infection through transfusions and control of congenital transmission of the disease. The evaluation team met with USAID, Ministry of Health, and project staff in La Paz, and reviewed project activities and accomplishments as well as plans for future activities. The team also reviewed project baseline data, visited project sites to inspect house and peridomicilary improvement, and reviewed laboratory facilities and the health education and community participation activities in Cochabamba, Chuquisaca and Tarija, including those managed by collaborating PVO's. This complex and multi-faceted pilot project has made important progress during a year and a half of activities. Extensive baseline data detailing the magnitude of the disease in the pilot communities have been collected. Low-cost operational schemes for house and peridomicilary improvement have been pretested, and manuals documenting these activities have been written. Laboratory work on insecticides and other aspects of vector control has been accomplished. Community organization and motivation and health education have received a great deal of attention as well. In general, the evaluation team felt that the project had made significant achievements. Many of the components necessary for a national Chagas' disease control program have been effectively pretested. In reviewing future project plans with project staff, evaluators made several recommendations which appear in detail in the report. The team strongly believes that the pilot project should be extended so that all of the technical information required for a national Chagas' disease control program can be obtained. (Author abstract)