Conclusions and Recommendations Objects, Outcomes and Success Everyone who participated in this project, and all those involved in the final evaluation collectively felt that the project had gotten off to a slow start. However, a review of the data shows that in spite of the time taken for the project to establish itself, tremendous gains were achieved throughout the life of the project, and while there is still room for continued growth, everyone was surprised at how far they had actually come. Plan managed to meet or exceed nearly every project indicator target by the final evaluation of this project, as demonstrated by a review of the data tables contained in the body of this report. Plan Cameroon successfully piloted IMCI in one district of Cameroon, leading the effort to introduce IMCI to the country, with the intention by Plan and the MOH (and UNICEF, WHO, HKI, PSI and others) to scale up IMCI throughout the entire country based on the results of this project (as well as the other two pilot districts carried out by UNICEF and WHO). Plan intends to submit another CS proposal, this time under the expanded impact category to scale up IMCI in four provinces in the country as part of a nation-wide scale up campaign being co-funded by several donors. The project staff witnessed a dramatic shift in the thinking and behavior of mothers /community members and health facility staff as they became more open to participation and learning. This motivated everyone to work even harder to amplify the incredible changes they knew the project was facilitating in an inhospitable environment plagued with poverty and disease, and in the face of tremendous hardship. They stated that the project has been very challenging, but also very rewarding! Achievements, Constraints and Other Factors Plan’s IMCI intervention in this child survival project, which began in 2000, preceded the government roll-out of IMCI in Cameroon by two years. Initially, Plan trained all of the 46 health facility staff working in the three project districts using a 6-day IMCI training, which was later to be followed up by the standard 11-day IMCI training recommended by WHO. The project then began working with the health facility staff to support them in fully integrating IMCI into their daily practice at the health centers in all three districts. Two years later, in 2002 the MOH initiated the pilot IMCI program in Cameroon, selecting three districts to begin with – Doume District in the East Province with Plan, Ngaoundere District in the Adamaoua Province with UNICEF, and Eseka District in the Centre Province with UNFPA (who eventually dropped out due to funding constraints, and WHO has assumed responsibility for this district). Thus, half way into this child survival project, Plan was required to redesign its IMCI intervention and scale it back to only one district (Doume District), which was selected by the MOH to participate in the IMCI pilot program for Cameroon. This situation greatly impacted Plan’s ability to demonstrate substantial success in IMCI implementation in the East Province. However, in spite of the situation, Plan did manage to demonstrate significant impact, and with a bridge-year ensuing upon the end of this project, they are certain to achieve additional results which will greatly impact the sustainability of CS project activities.
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