57 PHN 1991 Sector Review administratively constituted as a unit within the Industrial Development<sup>Bank, but operates in accordance</sup> with its own project eligibility and appraisal criteria,<sup>and is subject to the oversight of an 3utonomous</sup> DEF Management Committee comprised of representatives<sup>of relevant Government departments/agencies</sup> and non-governmental organizations. Bank and concessionary<sup>bilateral financing would be provided under</sup> the project to support DEFs first three years of operation.

# _Paksan - Family Health Project_

The project has three main objectives: (a) to improve the<sup>health status of the population of the</sup> two provinces; (b) to increase the effectiveness of the existing health<sup>care network; and (c) to build the</sup> institutional capacity to realize these objectives. The project<sup>has three main components: (a)</sup> strengthening health services from the village to the district<sup>level, focusing on improved maternal health</sup> services including family planning and integrating and<sup>expanding communicable disease control activities;</sup> (b) staff development focusing on improved staff capabilities and<sup>performance and increasing the number</sup> of female paramedical staff; and (c) management and organizational<sup>development focusing on improved</sup> management capabilities. The project will finance: construction<sup>or expansion of training facilities and</sup> limited health facility upgrading, furniture, equipment and<sup>transport; training costs; technical assistance;</sup> and incremental recurrent costs including medicines.<sup>It will be implemented by the provincial governments</sup> with technical support from local NGOs and universities.

## _Tunisia - Population and Family Health Project_

TMe Population and Family Health project aims to assist<sup>the Government of linisia (GOT) to</sup> lower both fertility and mortality, by targeting basic health care<sup>services to underprivileged groups with a</sup> strong focus on mothers and children. The quantitative target of<sup>the project are to recruit about 30,000</sup> new family planning acceptors per year in the public sector while<sup>continuing to serve over half a million</sup> women with such services through the project period. Further<sup>reductions in mortality and morbidity</sup> would be addressed through: (i) reducing regional disparities in<sup>access to basic health care (including the</sup> first referral level of care) and in the availability of resources;<sup>and (ii) improving the quality of Basic</sup> Health Care (BHC) of which Family PlanningrMaternal and Child<sup>Health services (FP/MCH) is a critical</sup> component. The project would provide: (a) works and equipment<sup>to BHC facilities to accommodate the</sup> strengthening of FP/MCH services and upgrade the technical<sup>quality of the services; (b) mobile clinics and</sup> vehicles to deliver family planning and other basic health services<sup>with a strong focus on underserved</sup> areas; (c) ambulances and equipment for the district hospitals; (d)<sup>works and equipment for five peri-urban</sup> diagnostic centers; (e) educational materials and expert services for a comprehensive<sup>pre- and in-service</sup> training program for staff who are to deliver the services; (f) expert<sup>services to improve strategic planning</sup> and monitoring capacities; and (g) spare parts and expert services for the<sup>development of a maintenance</sup> program for vehicles, equipment and buildings.

## _nia - Hospital Restructuring Support Project_

The objectives of the project are to support the Government policy<sup>in its effort to: (i) address</sup> major hospital internal efficiency issues to contain costs while improving<sup>quality of services; and, (ii)</sup> provide the information that would permit adjustments in financial burden-sharing<sup>by better linking actual</sup> utilization of hospital services to financial contributions. 'lb<sup>this end, the project would include the</sup> following components: (a) development of management capabilities and<sup>policy adjustments. The project</sup> would finance technical assistance, training and office technology<sup>(hardware and software) to develop and</sup> implement: (i) financial management and performance evaluation<sup>procedures; (ii) a Management</sup> Information System; (iii) the reorganization of the administration and<sup>patient registration units; and (iv)</sup>