Project Title: An Evaluation of the World Vision International Health Project at Kpasinkpe, (Overseas Area) in the West Mamprusi

District

Introduction:

Kpasenkpe

is remote village in the West Mamprusi District of the Northern region. The residents are basically farmers with production hardly going beyond subsistent levels. It is also noted for the production of shea nut which grows in the wild. Selling of shea nut is the main source of income to women in the community. The nut is sold on periodic market days at Walewale, which also serves as the District capital.

Introduction:
Kpasenkpe and its surrounding communities are

faced with major health problems including lack of health post and personnel, malaria, high infant mortality, jaundice, snakebite, malnutrition, diabetes piles and others as enumerated at a meeting held on 6th March, 2010. These major health problems attracted the attention of the World Vision International which came in with a health project to improve the health status of the people especially women and children through an integrated approach.

Aims of the Evaluation Exercise

the aim of the evaluation exercise is assess together

with the community members the impact of the World Visions project on the people of Kpasenkpe based on the aims and objectives of the Project.

Objectives of the Evaluation Exercise:

Identify the major health concerns of the people measure the knowledge base of the community members

on the prevention and management of malaria observe the activities that demonstrate environmental awareness of the people of Kpasenkpe measure the levels of reduction in the mortality of children under five measure accessibility and utilization of the health facility under the project
evaluate the impact of the project on other aspects of the

lives of the people of Kpasenkpe

Aims of the World Vision Project

To improve the health status of women and children

through integrated approach To improve the wellbeing of children, families and communities

Objectives of the World Visions Project

Educate the people of Kpasenkpe on the prevention

and management of malaria Educate the people on sound environmental management Improve access to essential health/nutrition services Reduce mortality of children under five

To achieve the stated objectives, the World Vision International undertook certain activities.
Activity I; education of the community members

on the prevention and control of malaria. Under this activity, they were taught the treatment of mosquito bed net with insecticides. They were again taught to drain stagnant water which serves as breeding ground for mosquitoes. The need to use treated bed nets was stressed. Regular Indoor spraying exercise by the Ghana Health Service.

Outcomes
Formation of three committees responsible for Repair and maintenance of borehole Sanitation committee Education

Evaluation
Members

of the community ascertain that the three committees were formed and are working

Members of the community were educated on Malaria

prevention and control and encouraged to use treated bed net but we observe that many of the community members were not having the net and those who do did not use it for the last two weeks for the reason that the weather conditions are not favourable for the use of treated bed net. They also cited the outbreak of CSM in the area as another reason. From their demeanour, it appear they prefer the spraying exercise to the use of the treated bed nets. It appears the committees

Activity II Maintenance of sound environmental practices.

Maintenance of sound environmental practices. This

has been done through a number of activities such as draining of stagnant waters, washing of hands, clearing of bushes around dwellings and many such related activities. The underpinning activity is education which is expected to change peoples attitude towards practices such as open defecation which can lead worm infestation and other complication.

Outcomes

Cleaner environment reducing sickness according to

the people.

Activity II De-worming and school feeding programme.

To improve the well being of children and indirectly

promote education in the area, regular de-worming exercise is carried out in the school for kids under five. Intestinal worms infestation was mentioned as one of the major health concerns in the area. Also to address the issue of malnutrition, school feeding programme has been introduced where children are given a balanced meal at school every day. The children in the school are linked through a special programme to people in a develop world who act as their parents and send them money and other items.

Outcomes
Reduction in malnutrition Increase school enrolment and retention Healthier children

Increased knowledge on personal hygiene

Evaluation
We observed that not all children benefited from the de-

worming exercise since they were not in school. It has been observed by some evaluation group members that the World Vision International might have kept some activities solely for school to encourage school attendance. The community members speak highly of the programmes at school with some saying the monies sent come to them and has been of immense help to their children and the family as a whole. The de-worming and the feeding programme were largely successful but the question of administering it only at school though good in promotion of school attendance, might have to be looked at so that it can consider those who may miss the exercise may be due to ill health. It was not clear if mob-up exercises are done.

Activity IV
To improve accessibility and utilization of health

services, the programme by the world Vision International built a health centre and equipped it with malaria drugs and of a special interest to the people anti-snake bites, which were kept in a fridge provided by the programme at the clinic

Outcomes
Provision of health infrastructure Equipment like fridge, furniture, and beds Provision of drugs

Reduction on the number of deaths from childbirth

and snake bites Improvement on health status of under five especially and children in general

Evaluation
The community members were full of praises for the

world vision for the project which has brought relief to them in many ways. They observed that the clinic is unable to handle all cases. A woman named one such conditions as atriatics(bloated stomach) The need for a permanent staff at the health center There should be an oversea ambulance at Kpasenkpe for referral cases to Walewale

Recommendations/alternatives
Integration of traditional medicine into the health

care system in the community The need to help train traditional birth attendance in view of lack of staff at the center. An opinion leader observed that long neglect of the traditional medicine is leading to practitioners forgetting the practice. Some practitioners present did not fully agree with him and claimed they could treat fracture, snake bites and other ailments

Impact of the WV Health Project on Other Sectors

Water supply World Vision understands the complex linkages between water supply, sanitation and health and to achieve improved health the programme decides to tackle the root causes of the major health concerns in the community by providing water (borehole) without disease causing pathogens. The programme also brought about improved sanitation through awareness.

Education
Increased enrolment and high retention rate Healthier kids means ability to go to school Elimination of truancy because something good may

happen
Livelihood

Loan to women help improve their well being

through enhancement of productive capacity

Recommendations/alternatives
During the discussion section with the community member, some

recommendations were made for attention of the world vision and government.

The need to add a drug store to the health center where drugs could be kept

in a good condition. Construction of the main road linking the district capital should be considered a priority if any form of development is to come to the people. The need to reduce poverty. According to the locals tractors are the only form of transport to the market centers and if they are lucky to get there after being tossed down several times. One woman observed, with roads linking the markets we can sell our produce at the market at a better prices The request for an ambulance by the people is a call in right direction since Kpasenkpe serves as a centre for other 11 smaller communities Rural electrification Provision of wellington buts may help reduce the number of snake bites

Recommendation/aternatives
In our view, the integration of the traditional health

care into the health delivery system of the people can help On the best method of malaria prevention, the programme should re-engage the people to chart the best way forward as it appears the people do not like the mosquito net The government should seriously consider opening up the area. This has the potential of reducing poverty in so many ways