Training of paramedical, auxiliary and community personnel (PAC), Asia

Evaluation covers the period 9/79-9/81 and is based on document review. Although the project is making valuable contributions in several countries (especially in India, Nepal, and the Philippines), start-up was slow and difficult due to problems both within and beyond the control of A.I.D. and the contractor, RTSA/A. Foremost, A.I.D. modelled the RTSA/A contract after a Latin American contract unsuited to the situation in Asia; directed RTSA/A not to assess each country"s training needs, use the training expertise of graduate countries (Hong Kong, Taiwan, Malaysia, and Singapore), or test innovative approaches to training; and inadequately monitored the project. RTSA/A negotiated very few subcontracts with LDC training institutions; devoted too much time to meetings of its Regional Advisory Group (RAG); used unrealistic planning; concentrated too much on graduate countries; and has had poor relationships with some personnel from A.I.D. and USAID"s. Finally, there were unanticipated political problems in several countries. Thus, as of 9/81, training was 27% completed (26% for in-country, 24% for regional, and 45% for U.S. training); 21% of the planned workshops had been held; and 18% of study and observation trips had taken place -- an overall 25% achievement of project outputs. By profession, training was completed for 115 (71%) nurses/midwives, 135 (88%) auxiliaries, 361 (15%) community workers, 84 (44%) trainers, and 152 (48%) supervisors. It is recommended that RTSA/A"s scope of work be amended to emphasize training of nurses, midwives, and auxiliaries; improve needs assessment and program planning documents; and omit counterproductive activities (e.g., additional meetings of the RAG). It is further recommended that RTSA/A: (1) halt regional courses and conferences until Asian Mission"s clearly express their interests and needs; (2) devote more time to planning; (3) cut costs (e.g., by being more selective in choosing training, and requiring host country contributions); (4) halt work in graduate countries; (5) establish a data collection system; (6) improve its semiannual reports; (7) subcontract with LDC training institutions when possible; and (8) hire a materials development expert.