Ex-post Evaluation

1-1. Background of the Project:

The Government of Egypt requested Project-type technical cooperation from the Government of Japan in the field of pediatric emergency medicine with the following aims: (1) to establish a scheme of pediatric emergency medicine, (2) to upgrade the training facility for pediatric emergency medical care and (3) to prepare a system of education on pediatric emergency medical care for the students.

1-2. Project Overview:

To establish an emergency pediatric medical system at CUSPH, the Project provided a training program for hospital managers and medical equipment maintenance personnel, and held seminars for medical practitioners at clinical tests and in newborn infant care departments.

(1) Overall Goal:

Pediatric emergency care in Egypt is improved.

(2) Project Purpose:

CUSPH functions as a central and model facility of pediatric emergency care.

(3) Outputs:

1) The concept of pediatric emergency medicine is introduced to CUSPH.
2) The system of providing pediatric emergency care service is improved.
3) CUSPH functions as a teaching hospital of pediatric emergency care for medical students, nursing students, and relevant medical personnel.

(4) Inputs (as of the Project’s termination)

Japanese side:

Egyptian side:

3-1. Summary of Evaluation Results

(1) Impact:

The project has a positive impact on the child mortality rate.
The project has a positive impact on teaching to introduce emergency care to medical students, nursing students and relevant medical personnel.

(2) Sustainability

The sustainability of the project has reached a sufficient level as the project is still performing the duties that were designed for; the project has trained staff that are capable of performing the duties; the supplies that were given to the project are still working; there is a good and continuous maintenance system.

3-2. Factors that have promoted the project

(1) Impact

The project is established in a University specialized hospital with a well trained staff.
The training program conducted in Japan had a good impact on the performance of the personnel which reflected on their duties in CUSPH.
The equipment given to the project was selected based on program needs and the maintenance system helps in keeping the work at high standard.

(2) Sustainability

The presence of well trained and enthusiastic staff together with a good infrastructure help in project sustainability. The administrative support from the director of CUSPH adds to the sustainability.
Staff have helpled to get donations to enhance the working conditions.

(3) Others

NA

3-3. Factors that have inhibited project

(1) Impact

High turnover of staff, especially nurses.
Irregular training with no documentation or evaluation for training courses.
Information system was not applicable.

(2) Sustainability

The case load has been doubled from 30000 to 60000 cases which affects the lifetime of the used equipment.

(3) Others

NA

3-4. Conclusions

The project has had a good impact and is sustainable, however, the module needs to be expanded to other hospitals through training of staff and technical support.

3-5. Recommendations

(1) The training programs that run in the emergency unit either for the physicians or to the nurses must be rearranged and evaluated.

(2) Establishment of a national network for pediatric emergency management could be the next step between different pediatric sectors all over the country.

(3) Establishment of a quality assurance system in the emergency care department is highly recommended.

(4) Measures to increase the effectiveness of an infection control program like regular evaluation and monitoring from central level and behavioral changes are recommended.

(5) A simple and easy use computer filing system must be introduced and applied to help in statistical analysis and medical recording.

(6) It is highly needed to supply the emergency unit with a staff of well trained nurses.

(7) A social marketing plan is needed to increase the awareness of the population about the services done by the emergency unit

3-6. Lessons Learned

Emergency Pediatric unit is an example of a successful cooperation project, as its outcome on the health and welfare of childhood is easily achievable. Training programs either in Japan or on-the-job training in Egypt by short term and long term consultants had a great outcome on the staff working in the pediatric emergency unit. To introduce the pediatric emergency unit in Egypt, there is a need to train a large number of physicians and nurses; this could easily happen if the emergency unit in CUSPH works as a center of expertise to train other health personnel in Egypt. The supplying of equipments to developing countries must be studied as a cost-effective strategy. The selection of the equipments must be through a team including engineers specialized in maintenance of medical equipments to be sure that the selected equipments are easy to maintain and cost-effective. Also the selection of the equipments must have suitable, well designed locations for use. The maintenance team should be trained on how to use different equipments together with the physicians and nurses to deal with any urgent problem.

Follow-up Situation

N/A