Evaluation

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Evaluation of the Primary Health Care Project in the Lao People's Democratic Republic
Completed: 2006

The principal objective of the Project was to improve health status of the people in the rural areas of the Lao People's Democratic Republic by reducing mortality from common diseases.

The specific objectives were to

• establish PHC services in the villages to improve access to basic curative and preventive services;
• improve the quality of health care from public and private sector providers; and
• improve the quality of drugs available to patients.

The study rated the Project as successful.

Summary of Findings

Beyond its main objectives, the Project helped strengthen the social organization in the villages through community participation in the management of the revolving fund. It raised the status of women in decision making by involving the women's union in health center activities. The Project also contributed to community cohesiveness by giving the village council an active role in the management of the revolving fund.

The revolving fund set up with seed money from the Project has become self-sustaining and continues to support the supply of drugs and operating expenses of the health centers.

The Project helped improve the quality of life in the remote northern rural communities and made people more aware of modern medicine, reproductive health, the prevention of common diseases, and the importance of hygiene.

The positive impact of the Project on health conditions and practices in the target areas, as a result of easier access to basic health facilities and services, has been significant, although the benefits cannot be quantified due to a lack of benefit monitoring.

Lessons Identified

Lessons from the Project have implications for future similar projects:

• Strategic location of health centers in remote areas.
  Service and coverage statistics indicated that, for investment in a health center facility to be practical and affordable, the catchment area should have at least 3,000–4,000 people. This lesson was taken into account in building the health centers in phase 2.



• Systematic collection and recording of provincial health data.
  Lack of baseline data in the pilot areas at the start of the Project made it difficult to assess the outcome of the Project.



• Information dissemination and public awareness activities.
  When people are informed, they can act accordingly. As the Project showed, regular training workshops conducted among health workers, and the dissemination of health information among poor people living in remote areas, can significantly contribute to the positive impact on health as measured by its indicators.



• Effective outreach program and use of local human resources.
  A significant contribution of the Project was to provide basic primary health care services to the rural poor living in remote areas. Employing local health workers and mobilizing village health volunteers increased the probability of project sustainability.



• Sustained flow of financial, human, and technical resources.
  Institutional reforms and appropriate budgetary allocation are needed to ensure that the project benefits are sustainable. Supervision, skills training, and skills upgrading need to be sustained to enhance the quality of services provided by health workers. The education of women is particularly important because of their role in the home.



• Coordination with other agencies.
  The Project demonstrated the advantages of partnership with other development agencies, collaborating from project preparation throughout project implementation. Funding agencies using the same project coordinating unit provided a model for aid harmonization, resulting in complementary financial and technical support that helped to sustain the Project.