USAID/OCEAC REGIONAL HEALTH EDUCATION PROJECT

THE EVALUATORS AGREED THAT THE BASIC PROJECT PURPOSE -- INCREASING PUBLIC HEALTH KNOWLEDGE AND THUS IMPROVING PUBLIC HEALTH STATUS -- WAS NOT SATISFACTORILY ACHIEVED. THERE WERE MANY INADEQUACIES IN THIS PROJECT. THE PROGRAM WAS WEAK ADMINISTRATIVELY FROM THE POINT OF VIEW OF COORDINATION WITH HOST GOVERNMENTS, WITH OTHER DONOR AGENCIES AND INTERNAL MANAGEMENT. NOR WAS A REALISTIC STRATEGY PROVIDED AS TO WHAT COULD/SHOULD BE ACCOMPLISHED IN THE AID TIME FRAME GIVEN THE RESOURCES AVAILABLE. ALTHOUGH THE PROJECT DESIGN WAS SUPPOSED TO ALLOW IT TO BE REPLICATED ELSEWHERE, IT WAS TOO RESOURCE INTENSIVE TO ALLOW FOR WIDESPREAD IMPLEMENTATION. ADMINISTRATIVE PROBLEMS WERE EXACERBATED BY (1) POORLY DEFINED LINES OF RESPONSIBILITY AMONG AID, OCEAC (ORGANIZATION FOR THE CONTROL OF ENDEMIC DISEASES IN CENTRAL AFRICA), AND THE CONTRACT PERSONNEL, AND (2) THE LACK OF A SUITABLE DATA BASE. THE PROBLEM OF IMPLEMENTING THE HEALTH EDUCATION PROGRAM, THE MOST CRUCIAL COMPONENT OF THE PROJECT, REFLECTED THE INADEQUACIES OF ADMINISTRATION AND DATA COLLECTION. IN THE SELECTION OF CANDIDATES FOR ADVANCED TRAINING HEALTH EDUCATION, LITTLE EFFORT WAS EXPENDED IN DETERMINING WHO WOULD BE THE MOST APPROPRIATE CANDIDATES, WHAT TYPE OF TRAINING WOULD MEET THE NEEDS OF THE RESPECTIVE COUNTRIES, WHERE THIS TRAINING COULD BEST BE OBTAINED OR WHETHER, IN RETROSPECT, THE EDUCATIONAL EXPERIENCE HAD BEEN EFFECTIVE. WITH REFERENCE TO TRAINING MATERIALS, THERE WAS A LACK OF SIMPLE, AVAILABLE, PORTABLE MATERIALS IN THE LOCAL LANGUAGE. IN THE REALM OF HEALTH DELIVERY, A SERIOUS GAP DEVELOPED BETWEEN THE TRAINING OF HEALTH EDUCATORS AND THE TRANSFER OF THEIR INFORMATION TO THE RURAL POPULATION. THIS PROBLEM WAS REFLECTED IN THE ORIGINAL AID/OCEAC PROJECT DESIGN AND RESOURCE ALLOCATION WHICH NEGLECTED THE DELIVERY COMPONENT.