Common use of Contributing Factors for Objectives Not Fully Achieved Clause in Contracts

Contributing Factors for Objectives Not Fully Achieved. The community census methodology is up and running in all the communities in Carabuco and Ancoraimes. In Ambana, 69% of communities have been censused, while in Puerto ▇▇▇▇▇▇ only 16% have been censused to date. The lack of census data makes it more difficult to track individual children. Although the cold chain is well equipped in Puerto ▇▇▇▇▇▇, there are health facilities in Carabuco, Ambana and Ancoraimes without refrigerators. In such cases, vaccines cannot be provided to children or women who visit the health post. The factor analysis approach for tailoring educational messages was not implemented during the project. Although use of “cartillas” is a good strategy for individual or small group education, materials are not available for new staff, especially volunteers. The formation of groups to learn about CS interventions has been successful in some areas, however in Ambana only 2 groups were formed during the life of the project, hence limiting educational opportunities. Quality control using checklists has not been fully implemented. There is great resistance to tetanus toxoid vaccination. Some women complain of swelling and pain in the arm, and others believe that the vaccine will cause sterilization. There is a general mistrust of modern medicine on behalf of the Aymara population. Another factor for low reporting of coverage rates may be attributed to poor previous record keeping. Some women claim to have already had 4-5 vaccinations and therefore refuse additional immunization.