Management Problems With AID's Health-Care Projects Impede Success

ID-81-24: Published: Apr 28, 1981. Publicly Released: Apr 28, 1981.

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The Agency for International Development (AID) is the principal U.S. Government agency that provides health assistance. Indirectly, the Department of State and many other U.S. Government agencies also support international health programs by channeling funds to international organizations and programs such as the United Nations Development Program. Recognizing that previous health assistance programs have not achieved their desired results because they concentrated on sophisticated urban-based curative measures, the government shifted U.S. interests to an emphasis on preventive health care in the rural areas of developing countries. GAO undertook a review of selected AID projects to determine the extent to which greater access to health care services has been achieved and the implementation problems which must be overcome to realize the long-term goal of improved health. Additionally, it examined the prospects of the efforts continuing after AID involvement terminates to ensure effective use of limited resources.

In its review, GAO found that many of the AID projects were successful in increasing access to health services, and most were successful in achieving their intermediate objectives such as training health workers, building facilities, administering immunizations, and providing initial stocks of medicine. However, problems were encountered during project implementation that involved logistic support, management oversight, and impact evaluation. These problems raise questions about the prospects of achieving the long-term health goals of the projects. Consequently, AID needs to become more involved in managing project implementation and lending more assistance to recipient countries in resolving the obstacles they frequently encounter.

Recommendations for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Administrator of AID should instruct mission directors and health officers to take a more active role in monitoring and managing health projects.

    Agency Affected: United States Agency for International Development

  2. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Administrator of AID should insist that periodic management reviews be completed regardless of the stage of project implementation.

    Agency Affected: United States Agency for International Development

  3. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Administrator of AID should insure compliance with procedures which require periodic progress reports on the implementation of health projects, identifying actual or anticipated difficulties and the proposed remedies.

    Agency Affected: United States Agency for International Development

  4. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Administrator of AID should require a more critical, realistic, and continuing analysis of the ability and willingness of host countries to continue providing financial and technical support when external assistance ends.

    Agency Affected: United States Agency for International Development

 

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