Organisational Development and Primary Health Care in Ganzi Prefecture, Sichuan Province, China - mid-term evaluation

Background

The Ganzi prefecture is located in the western part of Sichuan province and southern edge of Qingzang Plateau. It connects Sichuan, Yunnan, Qinghar provinces and Tibet Autonomous Region. It consists of 18 counties, 325 townships and 2 077 villages. There are many minority groups with Tibetans constituting 78.4% of the population of 980 000. The population are predominately farmers and nomads.

Purpose/objective

The main purpose of the mid-term evaluation is to assess the efficiency, effectiveness and impact of the Branch Development Project so far and to make recommendations for the next phase of the project.

Methodology

This evaluation was the first one externally facilitated in Sichuan Red Cross. The evaluation set out to be participatory and non confrontational. The Evaluation Team constantly made it clear that the evaluation was not trying to find fault or criticise individuals but to determine what could be learned from the process to date, what had been achieved, how it had been implemented and how in retrospect it could be improved. Terms of Reference were provided.

Data for the evaluation was collected in four ways: review of existing documentation, meetings and interviews, field visits and feedback from draft report.

Key findings

The project plan is consistent with the strategic planning of the RCSC five year plan for institutional development, humanitarian assistance and dissemination and the Norwegian Red Cross' Strategy for International Activities.

The original design and planning document for the project was not well supported by a log frame which has made evaluation difficult, but the goals and objectives are clear and remain relevant. The GPRC assured the team that the relevant document had been translated in part to Chinese and oral transference of the remainder to the document had occurred. Being primarily an Organisational Development Program with a Primary Health Care focus, the project is open ended with the process ongoing. All stakeholders were represented in the original assessment and are present at annual planning meetings. Documentation has improved as the project progressed, but without a revised log frame it is difficult to track the decision and planning process and the relation to the original objectives.

Management capacity, improvement of the Red Cross infrastructure, training, volunteer recruitment and dissemination of Red Cross knowledge are progressing well although dissemination of Red Cross Messages (RCM), re-establishing contact between separated family members, still has a limited coverage. Financial and reporting structures are well established although the reporting format requires some adjustment in order to reflect the objectives of the project and the related progress.

The hardware support and related training has proved useful, particularly in the computer section. China is very technology orientated and computerization has been appropriate. English training is the only training area where there seems to be few results. In order to attract future donors there is a need to be able to communicate in English. Today, the project relies on one translator.
Monitoring of the project has been ongoing but identification of the problems appears to rely on the visits of the project delegate. Identified issues appear to be adequately addressed.

The training programs have contributed greatly to strengthening the capacity at all levels. Training material has been developed with input from all levels and is to be translated to Tibetan where appropriate and compiled in manuals.

The two original counties in the project, Daofu and Luhuo have established their offices and completed leadership, ToT and volunteer training. They have approximately 40 ToTs and 800 volunteers who target around 4 000 families in 12 villages. Two further project counties, Ganzi and Kangding were added in 2003, and progress has been rapid - probably due to the previous experience.

Health promotion activities at the community level have progressed well. A baseline evaluation has assisted in identifying the health needs, and Focus Group
Gender and cultural issues have been addressed with a policy that aims to have 50/50 men and women with a cultural mix of Chinese and Tibetan in relation to the population of the community. Use of Focus Group Discussions has played a very important role at the community level particularly in empowering women and volunteer leaders.

Recommendations

As this is a pilot project with open ended goals, it is recommended that the project continue in the Ganzi prefecture until 2008 and possibly further but then limited to a monitoring and advisory role.
NRC
Ensure that SRC and GPRC have a common strategic vision and that team roles and responsibilities are clearly defined. Encourage good communication and improvement of coordination skills. Project Delegate should support SRC Project Coordinator to Team Lead in shared visits.
RCSC
Need to establish communication line to give feedback to province and prefecture level on project progress and its relation to national policy.
SRC
Support GPRC in separation process from government. Ensure policies and guidelines are in place and give input in content.
Commence strategic exit planning process with all stakeholders participating. It is important to secure the financial sustainability.

Comments from the organisation

NRC accepts the conclusions and recommendations of the evaluation report. The report was presented in a seminar where all stakeholders participated.