RUPll l.l I OF MA.) Vl'S lHAP Raa Atoll lntegrated Development Project END OF PROJI.'CT EVALJATION REPORT Fubrudry l'965 A Report Lo Gov rallllilL of the RepublLc of M"illvos Ullit(ed SL-LUs Agency for International Development [Letur|L lunal Ifu1,1mmA ststance Programs, Inc. Prelmrod by : Mr. Abdul Halnoud (GRN) Dr. Gladys A. Nott (USAID) Dr. Reid H. Whitlock (IHAP) TABLE OF CONTENTS List of Abbreviations ..... .. ............. Abb. 1 Glossary ......................... Gl° os., I U1. S. Assistance ............... *..* I Bxchange Rate ............................. .. II Acknovledgements ...... ***............... iii Summary, Conclusions and Recommendations ........... iv 1. INTRODUCTION Project Description ............ 1 Raa Atoll .................... 2 Purpose of Rvalution ........... .... 3 Members of the flva]uation Team ............ 4 Other Bvaluations ................ I...... ... 4 Logic of Sequencing .................... 4 II. METHODOLOGY 5 III. HBALTH Overview .................................. 13 Method . ................. ............. ........ 13 Objectives ......................... 14 Setting ...................... ............ 14 Activities ; Hospital Construction ............ 15 Ilospital Management .............. 21 Intestinal Parasite Eradicatton ...... 26 Water and Sanitation ................. 30 Rainwater Catchmont Tanks ....... 31 Human Waste Disposal ............ 46 Manpower Training ................... 56 Community Health Workers ........ 57 Foolhuma Training .............. 62 Family ltealth Workers ............ 67 Fina Comments ..................... ........ 75 Dissenting Opinion. .................. .. ... 78 0-1 IV. AGRICULTURE Method . ........................ Overview ...... ... 79 ................. .. ... ..6.. 79 Project Targets .......... .. ... ..... ... 80 Agricuitural Extension Training ............ s0 Reforestation ............. .. ....... .. 835 Bat Eradication . ..... 6 .... 86 Rat Eradication .............. oo.......**6 8 Gardening Training. ..... ... o...... .. o ... 89 Conclusions ............ ..... 92 V. EDUCATION Method .o........o........... ........... o. .9 The "Other Activities" Budget Line 99 Education As A "Felt Need" .............. 100 Schools....................... ...0 .. 0 102 Teacher Training and Adult Education 107 Raa Atoll rraining Center .... ......... 109 Imoact and Self - Sustainability ............ 109 VI. INCOME GENERATION Method ... ....... ..o......... Goo ..... 112 Income - Oriented Activtties ..... *........o. 113 Overview of the Lcan Program ........... ** 114 Establishment of the Loan Program .......... 116 Loan Supervision and Administration ........ 116 Loan Program Operating Costs . 122 Loan Distribution ..... .... .. 126 Loan Beneficiaries .... .. .*. ..... ...... 130 Impact and Self - Sustainability ............0 137 VI1. COMMUNITY BASED INTEGRATEDRURAL DEVELOPMENT Method ................. ... $000000... 141 Overview: "Solf-Help" and the CBIRD Appro~ach.,. 141 COIRl in the Maldiviani Contogxt .............. 146 Impact and Self - Sustdinability o........... 150 4) VIII. PROJeCT BUDGBT. ADMINISTRATION, REPORTING AND 8VALUATION. Method ......................................... 154 Budget .. .. .. ......... ***. .. .. .. .... 15 Administration, Coordination and Logistics ....... 160 Reporting and Technical Backstopping ............ 161 9valuation ............................... 163 IX. CRITIQUB OF THB LOGIC AND PHILOSOPHY OF THE PROJECT Method .......................................... 169 Project Aettvities: ......................... 169 The Linkage Betwoon Project Activities ... 169 The Phasing of Activities ........ 175 The Target Group............................. 178 The Project Managers........................... 181 Length of Project Life ........................ 181 Plexibility ................ .......... ......... 183 The Raa Atoll Project As A Pilot Project ....... 184 Conclusions ...................................... 185 Dissenting Opinion .............................. 187 APPBNDICBS 1. (Introduction) A. List of Documents Consulted .................... 188 B. Population and Lane Area for Islands in Raa Atoll .............. 191 2. (Methodology) A. Scope of Work .................... 192 B. USAII) Attachment E: Outline for Bvaluation of PVO Field Support Grant ................... 198 C. List of People Mot .................... ... 201 3. (Health) A. Growth Monitoring Results, Raa Atoll .......... 204 B. Status of Health Sector Targets ...... 06....... 205 C. PHW Survey. Selected Results .................. * 206 4. (Agriculture) (None) ........... ............ 208 S. (Education) A. Education Pact Sheo t ........................ 209 B. IHAP - Orgaiisod Adult Education Courses ..... 210 6. (lanc.mu Goneration) A. Letter of Agruumunt: Ria Atoll Loan Program ... 211 B. Financial Analysis of Rau Atoll Loan Program .. 224 7. (Community Based Integrated Rural Development) None ........................................ 226 8. (Budget and Reporting) A. RAIDP Overview of OPG budget and. Expenditure per 27 January 1985 ............. 227 B. RAJOP Overview of Expenditure and Contributions Administered in the Maldives per 27 January 1985 229 C. Outline Proposal for a Three Year follow-up 230 lWk.iation of RAIDP 9. (Critiqtqe of the Logic and Philosophy of the Project) A. Summary of Project Targets and Achiovuwsnts 133, LIST OF TABLtS IN THE TEXT Sum.. 1 Logical Framework (Reduced Form) for IHAP Rua Integrated Development Project ......... viii 11.1 Logical Framework Matrix ................. 7 111.1 Referrals to Malo'Central Hospital ........ 18 (April-Docombor 1984) 111.2 Approximate Comparative Costs, Rau Hospital vs. Seenu Hospital ........... 20 111.3 Hospital Staffing .................. ..... 25 111.4 infant Mortality Changes Over line ........ 29 111.5 Primary Sources of Drinking Water ........ 31 (Nat tonwido) 111.6 Water Tank Data .... ..................... .... 34 111.7 Comparative Water Tank Costs (a&b) ........ 36-7 111.5 F11W Responsibility for Water Tank Oporation/Maintonance .... ...... ... 45 111.9 Primary Defecation Areas (Nationwide) ... 48 111.10 Maldive Ash Toilet Construction .......... 53 111.11 Comparative Toilet Facility Costs . 57 111.12 Rau Atoll Manpowor Status 0. ........ S9 111.13 Provision of Antonatal anti Delivery Care (Nationally) .. ................. 63 111.14 Relative Advantagesof Training Older and Younger Foolhumas .... 0 ....... 66 III.15 PH Capabilities ......................... 68 111.16 IlAP Courses for FIWs .................... 69 111.17 Sample Growth Monitoring Chart .......... 72 111.18 Method of Selecting for FIIW Training ...... 74 111.19 Raa Atoll Health Related Indicators ...... 77 V.1 Education and Training Targets and Achievomonts ...................... 103 V.2 Status of School Construction ............ 103 V.3 Status of Furniture Construction ........ 103 V.4 Comparative Status of School Buildings : 1982 - 1985 ............... 106 V.5 IHAP Courses for Teachers in Raa Atoll ..... 107 VI.1 Number of Loans Being Financed,by Type of Activity and Average Value of Loan ..... 127 VI.2 Number of Applications Outstanding for February Review, by Type of Loan and Average Value of Loan ................. 129 VI.3 Distribution of Loans by Size of Loan ...... 134 VI.4 Monthly Incomes Reported for Representative Island Occupations ...... 134 VI.5 Distribution of Loan Applications Awaiting February Review by Size of Loan ........ 135 VIII.1 Project OPG Budget Allocations 1982 and 1984 and Expenditure in Maldives to 27 January 1985 ....................... 155 VIII.2 Total Project Expendituro and Contributions in Maldives to 27 January 1985 ....... 157 VIII.3 Allocation of Total Bxpenditare and Contributions in Maldives to 27 January 1985 .%............... ,..... 158 Vll1.4 Allocation of time on Final Evaluation Mission .................... 166 IX.1 Project Activities (By Category) ......... 170 IX.2 Activity Linkage Flow Diagram ............ 172 IX.3 Duration - of-Project Trade - Offs ........ 180 Naps, Graphs and Charts map Summ. I Ropublic of Maldives ................ v Map Summ. 2 Ra Atoll ............ .. .* .. VII Graph V.1 Progross of School Construction Through Time .............. 105 Chart V1.1 RALP Procedures for Processing Loan Applications ......... 120 Abb I - LIST OF ABBREVIATIONS Documents Frequently Referred to In Text: Bight Months P.R. Bight Months Progress Report (October. 1982) B.". Bxtension Proposal (OPG Extension Proposal, 1984) P.P. Project Proposal (Proposal for the Raa Atoll Integrated Development Project, 1961) QPR Quarterly Progress Report (11 Prepared Since Project Commoncement) Other Abbreviations ASM Assistant Bank Manager (BON) AHSTC Allie0 Health Services Training Center AID (United States) Agency for International Development BON Bank of Maldives "Bonnie and Peter" Bonnie Kittle and Peter Buijs. (Project Managers) CBIRD Community Based Integrated Rural Development ChW - Community Health Worker OPH - Department of Public Health BDC - Education Development Center PAO - Food aid Agriculture Organiza­ tion (of the United Nations) FHW Famity Health iorker - Abb. 2 - GA - Grant Agroomot GRiM - Govornmont of Republic of Maldives IDC Island Development Committee IHAP - International Human Assistance Programs, Inc. IHAP/Col or CMB - IHAP/Colombo IHAP/N - IIIAP/Maldives IHAP/NY - IHAP/Now York IHAP/Ria - IIIAP iHeadquartors in Raa Atoll IRD Integrated Rural Development MAA Ministry of Atolls Administra­ tion MAT - Maldives Ash Toilet MCH - Maternal and Child Health NN Major Medical MOAG Ministry of Agriculture