USAID anti-malaria project : mid-term evaluation, July 1-27, 1981

Special evaluation covers the period 8/79-7/81 and is based on document review, site visits, and interviews with RTG and project officials. Although the project has wrought considerable improvement in Thailand's anti-malaria activities, there is little chance that its overambitious goals for reducing mortality and morbidity will be achieved. Reported malaria cases have increased from 303,173 in 1979 to 397,491 in 1980 and P. falciparum cases from 58.16% to 68.5%. Major problems include: budgetary and time limitations; high inflation; uncontrolled migration within and among Thailand and neighboring countries; the practice of rubber tappers working at night (increasing their exposure); and conflicting RTG-AID bureaucratic systems. The latter problem is now generally resolved. A total of 15,000 (vs. 20,000 targeted) village volunteer malaria collaborators (VVMC's) have been trained. Training of VVMC's was preceded by training of instructors who then trained 552 RTG zone and sector personnel who in turn trained VVMC's in 2-day sessions. VVMC training was delayed in some zones because complete malaria kits were not available. Only 2 of 7 U.S. Master's fellowships have been filled and due to lack of qualified candidates it is unlikely the remaining 5 will be filled; 4 (of 7) in-country Master's slots are filled, and U.S. and third-country observation tours have been conducted for officials. High-quality health education materials (posters, leaflets, etc.), have been produced, some in Thai and some in the Yawi (Malay) language. Health education equipment has just begun to arrive. No personnel have yet been trained in health education methodology; courses are planned for 1982. Joint WHO/AID research findings on treatment regimens are being incorporated into the malaria program's operations and research on biological control measures is underway. The headquarters research facility has been built; construction of additional training facilities, not yet begun, should be finished early in 1983; and 150 new malaria clinics will open by the end of 1981 and the remaining 100 planned by the end of 1982. Cooperation between the health services and the malaria program is generallly good. Several recommendations are made.