Table 2.

Common characteristics of four projects with long–term evidence of impact on child mortality*

Characteristic	Hôpital Albert Schweitzer (Haiti)	Matlab MCH–FP project (Bangladesh)	CRHP–Jamkhed (India)	SEARCH–Gadchiroli (India)
Basic project characteristics:
Year established	1956	1965	1970	1986
Population of catchment area	150 000	100 000	300 000	80 000†
Range of services provided:
Is a comprehensive array of child health services provided? These include health and nutrition education, diagnosis and treatment of acute childhood illness, referral of seriously ill children to a higher level of care.	Yes	Yes	Yes	Yes
Is a comprehensive array of maternal, reproductive health, and family planning services provided? These include health and nutrition education, provision of antenatal care, management and/or referral of obstetrical complications, provision of postnatal care, and provision of a wide range of family planning methods	Yes	Yes	Yes	Yes
Are general curative services provided? These include treatment of common childhood illnesses and management (including referral when indicated) of serious childhood illnesses in the community; care for acute illnesses among patients of all ages in health centers, and referral of seriously ill patients to higher levels of care.	Yes	Yes	Yes	Yes
Are surgical and/or other hospital inpatient services provided?	Yes (operates its own first–level referral hospital with advanced surgical capabilities)	Yes (operates its own first–level referral hospital with no surgical capabilities)	Yes (operates its own first–level referral hospital with advanced surgical capabilities)	Yes (operates its own first–level referral hospital with some surgical capabilities, eg, cesarean section)
How strong is the referral system from the community to higher levels of care at fixed facilities, including hospitals? In all four projects, a first–level referral hospital is integrated into the project. However, all surgical cases at Matlab are referred to the government district hospital as are more complicated surgical cases at Jamkhed and SEARCH.	Very strong	Very strong	Very strong	Very strong
Health project management and support:
Does the project have a strong system of management and supervision led by competent and dedicated professionals?	Yes	Yes	Yes	Yes
Does the project have a record of accomplishment in treating patients and clients with a high level of respect?	Yes	Yes	Yes	Yes
Does the project have a record of maintaining supplies and drugs?	Yes	Yes	Yes	Yes
Nature of community partnerships/community involvement:
How strong is the partnership between the project and the community?	Fairly strong	Fairly strong	Very strong	Very strong
How strong is the level of trust of the community in the project?	Very strong	Very strong	Very strong	Very strong
Role of community–based workers:
Are CHWs an integral part of the project?	Yes	Yes	Yes	Yes
Do CHWs receive financial support?	Yes	Yes	Yes‡	Yes
How strong is the training and support of CHWs?	Very strong	Very strong	Very strong	Very strong
Do CHWs have routine contact with all families through visitation of all homes?	Yes	Yes	Yes§	Yes
Do CHWs provide essential child health services in the home?	Yes	Yes	Yes	Yes

CHW – community health worker

*Some of this information is based on the authors’ field observations and discussions with project leaders and is not contained in written documents.

†The part of the SEARCH project area with documented declines in infant mortality has 40 000 people.

‡Although the CRHP CHWs do not receive a salary, they do receive special training and access to credit to enable them to become economically self–sufficient through their own income–generating activities. CRHP ensures that their CHWs have enough income to meet their needs.