Revalidation of the rural health support project: Ministry of Health Sudan.

During May and June of 1983 a public health physician Dr. R. Mack and an economist Dr. D. Dunlop conducted a revalidation analysis of USAID/Khartoums Rural Health Support Project (RHSP) which was 1st designed in 1980. A primary concern of this project was the economic question of whether Sudan could continue to financially sustain health activities initiated under the RHSP. The managerial capabilities of Sudan to implement the project were also in doubt. Project discontinuation was a potential recommendation option. The consultants examined projects documents and previous consultant reports; interviewed Ministry of Health staff and other concerned individuals; analyzed the current and future status of the Sudancese economy in the health sector; developed a revised project implementation plan which reflects concern for handling recurrent costs; and identified ways of increasing the cost effectiveness of health programs and increasing the coummunitys ability to finance its own health care. The above issues were viewed in the context of achieving the main objectives of management strenghtening maternal and child health/ family planning strengthening and primary bealth care strengthening. The findings indicate a continuing deterioration in the economic status of the Sudan since the implementation of the primary health care program. This has adversely effected several important aspects of the health care system. The consultants however found many innovative ways local people finance ther health care needs. A lack both of sufficient systems to provide timely and pertinent information and regular supervision of periphery workers was noted. A careful analysis of past USAID efforts to inprove the drug procurement logistics and distribution system was made. Efforts to advance training in maternal and child health and family planning were reviewed. The resulting recommendations (strengthening management planning budgeting the logistics and supply system and maternal and child health and family planning services; training; and research) form the basis of contractor implementation plans.