Zimbabwe rural health services

Evaluation covers the period 5/80-5/81 and is based on site visits, review of Ministry of Health (MOH) records, and interviews with project personnel. Despite delays in A.I.D. disbursements and weak MOH monitoring of implementation, the project -- especially considering its emergency nature -- has been a success. All funds have been expended to repair 180 clinics. Of these, 139 have reopened; 21, which never closed but were damaged, were repaired and re-equipped; 24 are under construction; and 17 remain incomplete or unstaffed. However, all those under construction and 13 of the 17 now closed should be operational by 8/81. Although at least one staff house has been built for all but six clinics and 128 clinics have received latrines or flush toilets, only 56 are fully equipped and furnished; drug supplies, while difficult to judge, appear insufficient; and because the cost of restoring water systems was severely underestimated, only 90 clinics will have piped systems. As an added bonus, many inputs (construction and furnishings) have been of local origin. A final implementation status report (in tabular form) should and is being prepared by the MOH to document the final status of clinic and staff housing construction; supplies of furnishings, equipment, and drugs; restoration of water supplies and latrines; installation of A.I.D. symbols; staffing; and cost per clinic. Although unplanned, the project yielded a fairly complete set of baseline data on rural clinics which will be useful in future planning. In similar future projects, more attention should be given to monitoring activities and project reporting, and verifying baseline data. Cash flow shortages can be avoided by advancing all project funds or prepositioning checks with USAID/Z for delivery to the GOZ upon presentation of disbursement documents.