Case Study: Advising the Namibian MoH on a PHC Project You are responsible for advising the MoH on the development of a PHC project in the Caprivi region of Namibia. There is $800,000/year available for the next four years to be used to improve health status and primary health care services (including water and sanitation, if you wish). The project must include a mid-term and final evaluation.

Population: 90,000 14,528 sq. kilometers; One major town (Katima Mulilo) Major Occupations: subsistence farming and fishing 61% of children under 5 are registered with civil authorities (i.e. births registered) Health facilities: 1 hospital; 3 health centers; 23 health clinics (for 77% of population clinics are nearest health facility); 3/10 have regular water supply and electricity; Human resources: doctors at Katima Mulilo hospital only, nurses at other facilities. HIV highest prevalence (35.6%) in the country TB – high prevalence, including of MDR TB Caprivi Region

MMR 449/100,000 Endemic Malaria IMR 78/1000; Under 5 mortality 93/1000 Recurrent floods (Zambezi and Chombe rivers, measles, meningitis, influenza, diarrheal disease Les than 10% of HH have “improved” sanitation facilities Population largely rural farmers, fishers 30% teen pregnancy rate, 18% of women first intercourse by age 15 Appear to be a few NGOs and other private health facilities in the region

1. What questions should you be asking to inform your project development? 2. What kind of data will answer your questions? 3. Where will this data come from? 4. How will you obtain this data? 5. How reliable will it be? 6. What are the costs of getting the data? 7. How will you assess the project impact? DISCUSSION QUESTIONS

Information (Indicator/data point) Data Source Quality 1-poor 4-good Problems and concerns? Time required Cost 1-5 1=low 5=high Think about the information you would like to know to develop and evaluate the Caprivi primary health care project Case Study Exercise