TIHAMA PRIMARY HEALTH CARE

Three 3 centers, 12 subcenters, and 250 community-based health units will be established. The PHC system will focus on maternal/child health and nutrition education and will emphasize training of PHC personnel over construction of facilities. CRS will recruit foreign technical assistants who will be grouped into two teams: a field team composed of a physician, community health nurse, midwife, and a mechanic; and a Central Team in Hodeidah consisting of a midwife, MCH practitioner, and a pediatric practitioner. Under the direction of a CRS educator, the technicians will train 30 supervisors/trainers, who will in turn train up to 750 birth attendants and PHC workers, 40 community health nurses, and 12 medical assistants. Training materials will be developed for each of the above occupations, and workshops and seminars will be organized on a regular basis. Local Development Associations (LDA"s) will select PHC providers for their communities and will decide whether to use existing facilities or construct new ones. A.I.D. will establish a capital credit fund to finance health service proposals submitted by LDA"s. In addition, a cost accounting system and a referral system for high-risk patients will be developed, community surveys (pre- and post-service) will be conducted, and operations manuals will be prepared for all project activities. Sixteen specialists will receive M.S. training (8 in the U.S., 8 in third world countries) in public PHC, and 40 technicians (20 in the U.S., 20 in third world countries) will participate in short-term programs. A.I.D. will also finance equipment, drugs, lab supplies, and stationery for the various health units. Other donors include UNICEF, the Peace Corps, and German Volunteers (DED). Amendment No. 1 of 6/23/82 extends the project for 2 years, reduces U.S. TA, and shifts focus toward refining/expanding the PHC system. Existing programs and resources will be surveyed, and exposed management problems addressed. TA will be provided to improve health care provider training, the coordination of health programs, and the involvement of villagers and LDA"s, among other things. The community baseline survey will be redesigned, the sample increased, and the means to repeat it developed. Health information/education messages will be disseminated via mass media, and a Yemeni media production capacity developed. (PD-AAL-660)