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Evaluation Report the Imcc San Lucas Primary Health

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Evaluation Report the Imcc San Lucas Primary Health IMCC EVALUATION REPORT THE IMCC SAN LUCAS PRIMARY HEALTH CARE PROJECT CHUQUISACA BOLIVIA FINAL REPORT May 2004 IMCC San Lucas Primary Health Care Project Evaluation Report Table of Contents LIST OF ABBREVIATIONS ........................................................................................ 5 EXECUTIVE SUMMARY IN SPANISH / Resumen Ejecutivo ................................ 6 1. Introducción y antecedentes...................................................................................... 8 2. Aspectos nuevos de la política de salud de relevancia al proyecto .......................... 9 3. El municipio de San Lucas y la población rural ....................................................... 9 4. La metodología de la evaluación ............................................................................ 10 5. El impacto del proyecto .......................................................................................... 10 6. Sostenibilidad.......................................................................................................... 19 7. Aspectos institucionales.......................................................................................... 21 8. Monitoreo y evaluación del proyecto ..................................................................... 26 9. Conclusíon .............................................................................................................. 27 EXECUTIVE SUMMARY .......................................................................................... 28 Sustainability of the IMCC model............................................................................... 41 1 introduction ................................................................................................................ 42 1.1 Project background ............................................................................................... 42 1.3 Methodology......................................................................................................... 42 2 Project background ................................................................................................... 45 2.1 Objectives ............................................................................................................. 45 2.2 Activities............................................................................................................... 46 2.3 Strategy ................................................................................................................. 46 3. Project Description and implementation................................................................ 50 3.1 Investments in health infrastructure, including investments in health equipment 54 3.2 Research into health and illness concepts and into health seeking behaviour...... 54 3.3 Institutional set-up and the project implementation arrangements....................... 55 4. Possibility of achieving objectives with the current strategies ............................. 58 4.1 Special considerations........................................................................................... 67 5. Relevance of the project ........................................................................................... 69 5.1 Relevance of the project organisation: the IMCC model ..................................... 71 6. Project sustainability ................................................................................................ 73 6.1. Training, primary health care management, and human resources management 73 Inti Pallay.................................................................................................................... 75 6.2. Infrastructure and equipment investment ............................................................ 75 6.3. Research and baseline work................................................................................. 76 6.4. Institutional aspects and implementation arrangements ...................................... 77 7. Conclusions and recommendations......................................................................... 80 7.1 Training and strengthening of PHC management and health resources management................................................................................................................ 81 7.2 Infrastructure and equipment donations ............................................................... 84 7.3 Research and baselines studies ............................................................................. 85 7.4 Institutional, implementation, and monitoring aspects......................................... 86 30.04.04 page no 2 IMCC San Lucas Primary Health Care Project Evaluation Report Annexes Annex 1. Terms of Reference. Annex 2. List of persons met. Annex 3. Workshop with hospital and IMCC staff on the project. Annex 4. Mini workshop with auxiliary nurses. Annex 5. Mini workshop with ACSs. Annex 6. Focus Group Discussion with women and men villagers, Canchas Blancas. Annex 7. Detailed summary of IMCC infrastructure and equipment investments with HAM counterpart funds, 2002-2003. Annex 8. Programme of the Evaluation Mission. Annex 9. Declaration of Alma-Ata, 1978. Annex 10. List of documents consulted. Annex 11. Operations Manual of the EPC (Manual de Funciones del EPC) 30.04.04 page no 3 IMCC San Lucas Primary Health Care Project Evaluation Report Mapa No. 35 VIAS CAMINERAS Municipio San Lucas P O T O S Í N S. Salvador Uruchini P Thaqo Q'asa R Rumi Rumi Rumi Pampa Ciénega Trigo Q'asa O Buena Vista V T'iu Pampa Torre de L. Pata Cancha I Bella Vista N A OTAVI na i u Huaiñumilla lq Torojchi C Chanca u P Moqo Pata Janq'oyu Jarca Mayu I Yayoma La Palca Pasla A Kanaja ta i San Martín Molle Tambillos v Villa Paz Qollpa Ci Qherqewisi Caichoca Villa Carmen Cruz Mayu Cruz Orqoyu Yapusiri Puca Cancha Canchas B. Jatun Cancha Chaupi c. Tambo Aguada Japo A San Lucas Huayllavi Laravinto Tambo Moqo Z Condoriri Sivinga Mayu U A POTOSÍ Murifaya Quirpini Q'ellu Q'ellu Cutanazo a l a R b Lecori Entre Ríos T'uru Pampa a Rodeo Qhocha S aca í D t Laja Q'asa Qhocha Pata u Pirhuani t Avichuca Caracollo u Sani Mayu U P Ocur Palacio T. Maica Payacota del C. Ch'illawa Y K'umuni San León D E P A R T M N O Qhewayllan Qollpa Q'asa Padcoyo Corma Malliri Q'eruri Tira Hoyo Churqui Ch. Miska Mayu Santa Rosa Pilalo Churqui P. Churisaya Torre Guanaya Sunchu Tambo Puca Loma Andamarca Chunchu San Pedro Sivinga Mayu Ojeda Huayllani TamboQ Habas Chacra Ajchilla Sacavillque Pichacani Coplasia CAMARGO Quirpini Laderas Chinimayu Phullaya Capira Esmeralda Terrado Rodeo Jatun Pampa Habas M. Qollpa M. Sacavillque G. ata P e ll 1ra SECCIÓN CAMARGO o Referencias: M 3ra Límite Departamental SECCIÓN INCAHUASI Límite Provincial Límite Distrital Capital de Sección Capital de Distrito Comunidad Camino permanente Camino temporal Camino de herradura Municipio San Lucas 2002 30.04.04 page no 4 IMCC San Lucas Primary Health Care Project Evaluation Report LIST OF ABBREVIATIONS ACS (s) Agente (s) Comunitario (s) de Salud / Community Health Worker ADRA (NGO) Agencia Adventista de Desarrollo y Recursos Asistenciales / Adventist Agency for Development and Human Resources AIEPI Atención Integral de Enfermedades Prevalentes de la Infancia / Integrated Services for Childhood Diseases ARI (s) Acute Respiratory Infection (s) ‘ CAI Comités de Análisis de la Información / Information-Analysis Committees CAP Conocimientos Actitudes y Prácticas / Knowledge, Attitudes and Practices CEMA Centro de Educación Para Mujeres y Adultos / Educational Centre For Women and Adults CCSUTC Confederación Sindical Única de Trabajadores Campesinos de Bolivia / Sole Union Confederation of Peasant Workers of Bolivia Danida Danish International Development Assistance DILOS Directorio Local de Salud / Local health Directory EDAs Enfermedades Diarreicas / Diarrhoeal Diseases EIB Educación Intercultural Bilingüe / Bilingual Intercultural Education EPC Equipo de Planificación y Capacitaciones / Planning and Training Team EBRP Estrategia Boliviana de la Reducción de la Pobreza (2004 – 2007) / Bolivian Poverty Reduction Strategy (2004 – 2007) FGD (s) Focus group discussion(s) HAM Honorable Alcaldía de San Lucas / Municipality of San Lucas IEC Information, Education and Communication IMCC Comité Internacional de Cooperación Médica / International Medical Cooperation Committee IRAs Infecciones Respiratorias Agudas / Acute Respiratory Diseases KAP Knowledge Attitudes and Practices LFA Matriz del Marco Lógico / Logical Framework Matrix LPP Ley de Participación Popular y de Descentralización / The Law of Popular Participation and Decentralisation MMI Mortalidad Materno-Infantil / Maternal Infant Mortality NGO Non Government Organisation O.C.I.ACS- MSL Organización Campesina Integral de Agentes Comunitarios de Salud del Municipio de San Lucas / Integrated Peasant Organisation of the ACS of San Lucas Municipality OMS Organización Mundial de la Salud / World Health Organisation PASACH Danida-financed Agricultural Sector Programme PHC Primary Health Care PIVs Promotores de Investigaciones de Vectores POA Plan Operacional Anual / Annual Municipal Plan of Operations SEDES Servicio Departamental de Salud / Departmental Health Services SUMI Programa de Salud Universal Materno Infantil / Universal Maternal Infant Health Programme 30.04.04 page no 5 IMCC San Lucas Primary Health Care Project Evaluation Report EXECUTIVE SUMMARY IN SPANISH / RESUMEN EJECUTIVO EVALUACIÓN DEL PROYECTO IMCC SAN LUCAS DE SALUD PRIMARIA 24/03/2004 Resumen: versión muy breve
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