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work as well as some specific ones-targeted at the individual REDES.   This may not be monetarily feasible (specific interventions) but it is worth mentioning in view of the fact that this project is expanding into malaria and ARI interventions.  Again, without a proper needs assessment any project is doomed, or will not reach its potential.

The results on diarrhea case management and nutrition show that there is still a great deal of work to be done.  As with any project that sets out to create change in a person’s behavior, time and the active participation of these person’s is necessary.  Another three years have been added to this project, which can be considered crucial for attempting to make permanent behavior changes.  Additionally, more interventions involving the community will have to be started.  The GALMES groups should be given more attention, this is the perfect channel for women to exchange ideas and learn from one another (and not only about health issues, but social matters also.)  Another way to involve the people is to work with the school teachers on lessons surrounding nutrition and personal hygiene.  The older children can then relay these messages to the family.

One final note, is that there has been quite a bit of staff turnover.  

For the upcoming extension program, attention should be paid to the capacity and number of HOPE Staff.  There is a core group of very qualified staff, and with support they will be able to train any incoming staff.  (This is especially important for the nursing positions.)

VI.  COST

At this date, not all of the expenses have been computed, but a rough estimate of the cost of this final survey is $10,000.00.  If you require a more specific answer, please contact Project HOPE directly.

References

1.

CS XII Baseline Survey, March 1997, pg. 10

2.

IBID  pg. 4

3.

IBID  pg.  15

4.

Respiratory Infections Conference, June 1997

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