Trip report to Peru

Special evaluation covers the period 11/80-10/82; no methodology is specified. The project has encountered many problems: difficulty in finding personnel, especially physicians and social workers, to collaborate; little knowledge of project methodology on the part of the coordinator and failure to request TA early on; the inefficient administrative structure of the Instituto; opposition by government officials, journalists, and community leaders in the two project areas (Arequipa and Chiclayo); and difficulties in clearing contraceptives and equipment through customs. The Arequipa clinic began operations in 4/81. Although the number of consultations rose from 9 that month to 310 in 12/81 (25% for FP and the remainder gynecological), during 1982 there has been only a 4% increase - due perhaps to deficiencies in promotional activities and to the presence of competing FP programs. CBD activities - which also decreased during 1982 - have had little success. The program offers a limited choice (Noriday and condoms) and products are available free elsewhere. The CBD manager has a poor relationship with promoters, little empathy with clients, and has been unable to organize activities effectively. Despite the deficiencies in Arequipa, a medical service and infrastructure have been established, the Instituto is well known, and there are some motivated individuals. The potential to serve as a base for expanding services to rural areas is present. In Chiclayo, the clinic, which opened in 5/81, has had to move three times and has had trouble finding competent doctors. Demand for medical attention increased 208% in l982 and new users increased 71%; 52% of services in 1982 were for FP. The CBD component in Chiclayo - despite well-motivated promoters and distributors, the Instituto's good standing in the area, and a variety of promotional efforts - has recorded only modest numbers of new users, with a drop in recent months. However, the number of active users increases every month. Detailed recommendations are made.