TIHAMA PRIMARY HEALTH CARE - OPG WITH CATHOLIC RELIEF SERVCES (CRS) OPG AID/NE-G-1685

Evaluation covers the period 6/80-6/81 and is based on an annual report prepared by Catholic Relief Services/Hodeidah (CRS/H), the implementing agency, and USAID/Y in-house review of project activities. Outputs during this first year were less than planned due to delays in recruiting staff and an unrealistic implementation plan. CRS/H has hired almost half of the technical assistance team (TA). Thirty men and 15 women were recruited for training as primary health care workers (PHCW"s) and local birth attendants (LBA"s). The Ministry of Health (MOH), however, refuses to support the LBA"s, most of whom are illiterate and lack the sixth grade education necessary to complete the PHCW and community health nurse curricula. In addition, an LBA curriculum is lacking. The Zaydiah health clinic was renovated and is staffed by Yemeni and expatriate health workers who served some 3,450 patients in 6 months. Nine villages receive weekly or biweekly visits from the trainer/supervisors with their trainees. The first baseline survey has been designed and trainees were recently taught to conduct the survey. Three village surveys are complete but data are still unavailable. The MOH has not yet decided on a location for the maintenance/repair workshop for project vehicles which are now being repaired commercially. Planning for project implementation has been inadequate in most areas; cooperation of the CRS project administrator with the MOH has been so unsatisfactory that MOH wishes to have her replaced. Delegation of responsibility has been insufficient. Trainees were recruited and training was begun prior to MOH clearance resulting in MOH"s refusal to pay salaries of 30 trainees. It appears unlikely that the project"s planned targets will be met. Action decisions include revising the project implementation plan; projecting second year costs; and obtaining an outline of baseline surveys completed to date.