WVRD/Uganda : final evaluation -- Bundibugyo child survival project : Bundibugyo District, Uganda

Data from the concluding Knowledge, Practice, and Coverage survey (annexed to the evaluation) indicate that of the project's 15 objectives, 11 were surpassed, 2 were slightly below end-of-term target (percentage of mothers receiving two doses of tetanus toxoid and providing sufficient fluids during diarrheal episodes), and 2 were considerably below end-of-term target (immunization coverage for children, percentage of mothers able to name modes of HIV transmission). Reasons given for not meeting the immunization coverage objective include periodic shortages of the vaccines, the conditions of the roads (especially during the rainy season when transport becomes impossible), the influx of immigrants from Zaire, problems with vehicles, and security issues. The project's accomplishments, however, are considerable. World Vision's presence in Bundibugyo has dramatically changed the demography of the area -- families are now larger because children are no longer dying. Demand for health services has increased, compounds are cleaner, water sources are protected, income-generating activities have been introduced and are showing results, communities recognize their responsibility to be involved, and local leaders, governmental officials, and bilateral agencies all recognize and acknowledge World Vision's remarkable accomplishments in the area. Large numbers of community volunteers and health personnel have been trained over the years, and the collaboration between these groups is remarkable The fundamental problems that brought World Vision to the area have not changed, however. Bundibugyo is still one of the poorest districts in Uganda, the population continues to be largely underserved, no other NGOs are operating in the district, and the conditions of the roads, which affect the transport of goods and persons, remain unacceptable. The project's immunization activities will likely continue with the assistance of UNICEF and Germany's Society for Technical Cooperation (GTZ), but most of the supervisory visits and training programs will cease. A skeletal World Vision staff will, however, remain in the area to plan for potential greater involvement in the future. (Author abstract, modified)