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maternal and infant care, the project should have a major impact on reducing matemal and infant mortality rates. The project's emphasis on substituting expensive brand-name drugs with Iow cost generic drugs will both benefit patients by reducing their financial burden during sickness episodes, and also make possible the introductioc of cost recovery, which would provide the Govemment with additional revenue required for morę efficient functioning of health services at all levels of the system. Short supplies of drugs have been one of the major problems of the present CSPS system, which has led to the underutilization of basie health facilities. Stocking the CSPS with essential generic drugs coupled with instituting cost-recovery would help overcome this major problem. It is also expected that community participation in the management of the CSPS would greatly enhance the population's trust in the reorganized health care system.

S.2 Provision of additional surgical facilities at the district Ievel should contribute to morę immediate medical/surgical interventions in emergency cases, and at the same time, reduce the clogging at the Regional and National Hospitals. Training of generał practitioners in abdominal surgery would break an existing bottleneck by inereasing the supply of doctors capable of performing acute abaominal surgeries such as appendectomies. Additional training to doctors at the district level would improve their skills in coping with inereased supervision of the CSPS, thus assuring improved performance of the basie level health facilities in the new decentralized health care system.

5.3 The nutrition comnonent would be a major complement to the IDA-financed Food Security and Nutrition Project (Credit 2414-BUR) by providing supplies of necessary micronutrients to the diet. In particular high rates of anemia among expectant mothers leading to Iow birthweights will be reduced due to supplementary iron to be administered during pre-natal care. Dispensing of iodine and vitamin A should greatly reduce incidences of iodine deficiency and vitamin A deficiency causing blindness. A feasibility study to be fmanced by UNICEF under the project should lead to actions to promote the importation of iodized salt and thereby resolve a severe problem of iodine deficiency throughout the country.

5.4 The endemic parasitic disease control comnonent would contribute to sustaining the success of the OCP. Possible reintroduction of onchoctrciasis through immigrants settling in the oncho-freed areas would be prevented through the devolution component's control system. Simultaneously, similar Controls should make it impossible for outbreaks of trypanosomiasis. Through these measures, seven million Burkinabe would remain protected from any recurrence of onchocerciasis. And about 17% (43,000 km²) of Burkina's agricultural lands—with relatively fertile soils-would remain safe for the production of foodstuffs and other agricultural commodities.

5.5 Through improved surveillance and education of the population substantial reductions in the incidence of dracunculiasis would be achieved. Although dracunculiasis is not a mortal disease, it leads fr* economic losses due to absence from work and/or school. Official estimates, based on village surveys, indicate that about 34% of the villages in Burkina are afflicted by dracunculiasis. Preventive action taken under the project would reduce the incidence of dracunculiasis considerably and make a substantial contribution to worker productivity in the rural areas. The estimated economic loss avoided through eradication would be a minimum of US$3 million per annum.