CARE International in Honduras
United States Agency for International Development (USAID)
Title II Food Security Program FY 2001 to 2005
Final Qualitative Evaluation
Tegucigalpa, Honduras
October 2004
Kirsten Johnson
Aida Maradiaga
Nelson Mejia
2
Acknowledgements
The evaluation team would like to thank the CARE staff for their assistance and
commitment to the goals of this evaluation, as well as the dozens of project participants and 
counterparts who dedicated their time, ideas and enthusiasm during our interviews and 
workshops. We would especially like to thank the CARE field staff who accompanied us 
for their unfailing support, good humor and above-standard driving skills.
3
Acronyms and Terms
Aldea Rural village
CAP Community Action Plan
Caserio Outlaying settlements of an aldea
CHV Community Health Volunteer
CODECO Community Development Council
Comision de Proyectos Commission that coordinates community projects
DAP Development Assistance Proposal
EXTENSA Food Security Extension Project
FFW Food For Work
FSP Food Security Program
GOH Government of Honduras
HOGASA Community Based Health Services Project
Mancomunidades Clusters of municipalities
PAC Community Action Plan
Patronatos Community organizations
PODER Rural Employment and Development Project
PP Producer Promoter 
Regidor/a Municipal official
UCS Community health center
UPS Government health post
i
Executive Summary
Introduction
CARE Honduras has hired an evaluation team to conduct a final qualitative evaluation of a 
Title II Food Security Program (FSP) implemented from FY 2001 to 2005. CARE’s
purpose for this evaluation is to measure impact and change as seen from the perspective of 
project participants. The findings of this qualitative evaluation are meant to complement 
those of the quantitative evaluation based upon a survey of 1800 households in the project 
area.
The evaluation team, comprised by an expert in sustainable agriculture and resource use, an 
expert in health and an expert in local governments, designed a field evaluation
methodology emphasizing semi-structured in-depth interviews with participants and
counterparts. Group interviews and (in the case of PODER) workshops complemented 
individual interviews. The team spent a total of eight days visiting project sites in the three 
departments where the FSP is implemented. 
Background
The overall goal of the CARE Honduras Security Program is: 
“To improve, in a sustainable manner, the food security of vulnerable populations -- at the 
household, regional and national levels -- in the extremely poor municipalities of western 
and southern Honduras.”
CARE implements its FSP in the Departments of La Paz, Lempira and Intibuca, selected 
because of their high levels of poverty, infant malnutrition and food insecurity.
To accomplish the overall goal, CARE carries out three separate, but complementary,
component projects: community health, agricultural extension and municipal capacity
building.
(i) Community Based Health Services Project (HOGASA). HOGASA’s main
objective is to improve access to and availability of health services by
establishing community based health centers (UCS) that provide volunteer
services to rural populations who are extremely vulnerable to malnutrition and 
infectious disease and where access to health services is extremely limited.
(ii) Food Security Extension Project (EXTENSA). EXTENSA’s main objective is to 
increase agricultural production and diversification by: training ‘model farmers’ 
(PPs) who, in turn, pass on their knowledge to other local farmers; channeling 
agricultural materials and equipment to farmers by means of community-based 
ii
revolving banks; and by promoting appropriate technologies and practices such 
as agroforestry, soil conservation and low cost improved grain storage.
(iii) Rural Employment and Development (PODER). PODER’s main objective is to 
strengthen the capacity of local governments and civil society organizations to 
improve livelihood security by organizing at municipal and community levels, 
food security committees; providing food for work (FFW) opportunities
(improved roads, local markets, reforestation, rural housing, and cook stoves).
Major Findings for HOGASA.
Significant Changes. The great majority of parents, community health volunteers (CHVs) 
and government health workers interviewed, state that there have been positive changes in 
the health and nutrition situation of mothers and infants. 
Those interviewed identify other changes, such as greater knowledge among mothers about 
the care of their children, greater access to health services and better housing, that result in 
improved overall family health and nutrition. 
Changes in childcare practices are focused primarily on personal hygiene, clean food
preparation, and clean dwellings. In addition, exclusive breast feeding until six months, and 
appropriate weaning food preparation, such as soft foods and more frequent feedings, are 
seen to have contributed to healthier babies.
In the minds of those interviewed, these changes can be directly attributed to CARE’s 
program. 
Benefits. HOGASA beneficiaries are families with children under two, pregnant women 
and breastfeeding mothers. In program communities nearly 100 percent of qualifying
families participate in HOGASA. Those interviewed report that children are the main
beneficiaries, but also say that women benefit since mothers have acquired new knowledge 
about childcare. 
Participants identify food assistance and a system of health attention based on CHVs as the 
two most important elements in the program since these have brought about improvements 
in their children’s health and nutrition. 
Parents state that they can feed their children better and improve their nutritional status with 
donated food. Parents also report that CHVs provide opportune attention and health advice 
result in their babies recovering from illnesses more rapidly and in fewer deaths.
Sustainability. All those interviewed consider that, given low incomes and inadequate 
agricultural yields that prevail in the project area, not all households will be able to achieve 
food self-sufficiency without the food donations provided by the program. Food assistance 
is considered indispensable to maintain adequate child nutrition. The overall message from 
parents, CHVs and government health workers is that CARE should not leave the region. 
iii
Those interviewed believe that the community health service based on CHVs as
sustainable, even without a CARE presence. However, they think that health volunteerss 
need active community and Health Ministry support in order to continue. Health volunteers 
are also motivated by additional training. Parents say that they plan to support their health 
volunteers by continuing to attend meetings and by providing moral support.
Program Integration. The evaluator was unable to find very much of a linkage between 
HOGASA and the activities of the other two projects in CARE’s Food Security Program. 
For example, households with children under two are not involved with EXTENSA
sponsored food production, nor do they receive support from organizations working with 
PODER. 
Major Findings for EXTENSA.
Significant Changes. By an overwhelming majority, farmers report and describe changes 
in their agricultural practices, farm assets, crop yields and cash income resulting from their 
participation in EXTENSA. It can be concluded that the technical and loan package
promoted by the project is appropriate in that it responds to farmer’s needs and their 
circumstances. 
EXTENSA’s strategy to address both short-term household needs, such as basic grains, and 
long-term investments in farm assets, such as agroforestry systems with high value
perennials, has been a success. The revolving credit mechanism designed to underwrite 
this dual-track approach to agricultural intensification, has met with widespread farmer
acceptance. Farm assets have increased significantly and risk has been reduced by means of 
diversification, soil conservation and micro-irrigation. 
The end result, as reported by farmers, has been in significant improvements in household 
grain self-sufficiency, lower rates of out-migration, greater availability of vegetables and 
(some) fruits for household consumption, more case income, and the expectation of future 
income streams when fruit trees mature. 
Benefits. Male farmers have been the principal beneficiaries of EXTENSA training,
extension advice, organization and material resources. Among this group, model farmers, 
who represent approximately 25 percent of project participants, have benefited from the 
largest share of the training, over half of the material resources and a key role in group 
decision making. 
Women represent a very small percentage of total project participants and farmer’s wives 
do not appear to take an active role in project activities, including training. Family
members do, however, benefit from increased and more diverse food availability, a key 
consideration in a food insecure region. 
EXTENSA appears to have generated few spread or multiplier effects in the larger
community, thus it cannot be said to have clearly benefited more than its own membership.
iv
Sustainability. Most EXTENSA participants who were interviewed have achieved changes 
in their farming practices, productive assets, and organizational capabilities that promise to 
increase their productive capacities and standards of living over time. 
The prospects for some farmers and groups are somewhat more fragile. These include: 
those who depend exclusively upon chemical fertilizers to increase yields; cash cropping in 
aldeas located far from markets or on FFW feeder roads; and BRHIS groups who depend 
on CARE to purchase and/or transport materials.
The EXTENSA extension and revolving credit model based upon model farmers and small 
participant groups has achieved significant change for a limited number of farmers.
EXTENSA staff has been directly involved in service delivery for these groups, who, in 
many cases, have become dependent upon them. CARE extensionists have not conveyed 
the concept that EXTENSA, like any project, has a clear beginning, middle and end.
Major Findings for PODER.
Significant Changes. PODER has helped bring about important changes in community 
organizations and municipal governments. In general, CODECOs and Patronatos
organizations have improved their planning and project implementation capacities,
coordinate more with one another and communicate more effectively with municipal
governments. The latter now dialogue with community organizations and take Community 
Action Plans (CAPs) into account.
CODECO and Patronato are now less politically oriented and more focused on technical 
planning criteria. Municipal governments, having improved their management capabilities, 
(vision, strategies, the use of legal mechanisms to promote citizen participation, office
equipment) are now in a position to carry out genuine municipal development.
Benefits. The main beneficiaries of these changes have been community organizations, (the 
general membership and the directories) municipal governments, (authorities and staff) and 
ordinary households (insofar as families form part of community organizations such as
women’s groups, parent associations, water user committees). 
Sustainability. Food security plans do not exist, as such, at the community or municipal 
levels. Nevertheless, community leaders and municipal staff possess the capabilities and 
knowledge to develop municipal food security plans. Despite this, the program’s municipal 
exit strategy does not include such a plan. Therefore, it is difficult to guarantee the actions 
promoted by CARE in this regard.
The main processes providing sustainable change include: training in organizational
strengthening; technical advice and support to improve municipal management; and inter￾municipal support and shared experiences within the framework of mancomunidades. 
v
Recommendations.
HOGASA
Recommendation 1. CARE should continue with its current approach to community health 
outreach since this model has succeeded in bringing health services closer to populations 
that are the most distant from health centers and, moreover, beneficiaries consider these 
services to be important and are satisfied with the results.
Trainings given to mothers on food preparation, especially in communities where the
program is close to leaving, should put more emphasis on recipes using local foodstuff and 
less on donates foods, since the latter will be available for only a short time.
Recommendation 2. HOGASA should continue to target mothers and children under two, 
given that these are the groups that are most vulnerable to malnutrition. CARE should 
reinforce its messages in reproductive health, since participants mention changes in this 
area less frequently.
Recommendation 3. CARE should strengthen efforts to promote income generation and 
food production, involving as many families as possible, in particular, the poorest
households.
Recommendation 4. CARE should ensure Health Ministry and community support for the 
community-based health model. Continued trainings, supervision and training materials for 
CHVs are particularly important in this regard. It would be useful for CARE to include a 
module on the right to health care in HOGASA training, so that parents and volunteers are 
more informed as to what they can demand from government health services.
Recommendation 5. Activities of the three component projects should be more integrated 
at the community level. Families with children under two should be included in EXTENSA 
food production activities, thereby benefiting this vulnerable group. PODER should also 
work with and provide more support to health groups. 
EXTENSA
Recommendation 1. The basic EXTENSA technical and loan model should be retained in 
the upcoming DAP. The menu of specific agricultural practices and crop varieties should 
remain flexible in order to adapt to the different agroecological conditions that exist in its 
large and diverse project area. Project management should consider a small livestock
component featuring chickens and pigs. The solar stove and pump pilot should be
evaluated to determine whether costs outweigh benefits. 
Recommendation 2. EXTENSA should retain and build upon its current model. Small￾scale drip irrigation systems should continue to be promoted where feasible. However, 
EXTENSA should continue to emphasize agroforestry and soil conservation solutions for 
rainfed fields since these (i) have been demonstrably successful in the current DAP and (ii) 
remain the principal resource base of the majority of farmers in the project area.
vi
Recommendation 3. One of CARE’s top priorities for the upcoming DAP should be to 
design clear and effective measures to increase community access to EXTENSA’s benefits, 
either through expanded membership or explicitly designed measures to enhance spread or 
multiplier effects. EXTENSA should also reduce the benefit gap between model farmers and 
other farmers. Most importantly, EXTENSA needs to design effective pathways for
significant numbers of women to become actively involved in project activities and thereby 
enjoy a share of its benefits. 
Recommendation 4. During the final year of the current DAP, EXTENSA should take steps 
to assist dependent BRHIS groups to purchase their own inputs. CARE should also conduct 
a study of options for farmers who depend exclusively on chemical fertilizer and herbicides 
to increase yields. Integrated pest management techniques for grain and vegetable and fruit 
crops should be an integral part of EXTENSA’s technical extension package. Marketing 
should be a central theme in the final year of the present DAP. These more sustainable 
alternatives should be incorporated in the upcoming DAP design. EXTENSA should also 
coordinate with PODER to ensure that municipal governments commit to the future
maintenance of FFW roads. 
Recommendation 5. EXTENSA needs to use the final year of the current DAP to focus on 
steps that help BRHIS groups make a successful transition to independent operations. This 
will require planning with groups slated for a final year. It will also require CARE staff to 
deploy different attitudes and skills given that CARE extensionists need to step back from 
tasks that participants will need to accomplish by themselves and become more facilitators 
than doers. CARE should also build into the following DAP a straightforward three phase 
project cycle design and make it the centerpiece of its on the ground operations. 
PODER
Recommendation 1. CARE should continue its support for CODECOS and Patronatos, 
focusing on standardizing their regulations. It is also important to advise municipal
governments on mechanisms that will ensure that Community Action Plans are included 
within Municipal Strategic Plans. 
Recommendation 2. Strengthen the technical capacity by developing a technical guide 
summarizing the methodologies and procedures that CARE has formulated over the course 
of the project. Continue to support municipal management, in particular, instruments for 
agreements, planning and municipal administration.
Recommendation 3. It would be worthwhile for municipalities to inform the wider
population of the important actions undertaken by their community organizations and
municipal governments on behalf of the general population.
Recommendation 4. Undertake sessions at the municipal level focusing on a transition 
plan to prepare for CARE’s withdrawal. The plan should include an integrated food
vii
security program encompassing HOGASA, EXTENSA and PODER activities that can be 
carried out after CARE leaves.
Recommendation 5. CARE’s organizational strengthening should have a better focus. This 
requires differentiating among different groups and municipalities according to their
strengths and weaknesses. PODER should also take the mancomunidades into account 
since these are important to future municipal management.
1
Table of Contents
1. Introduction 1
2. HOGASA Findings and Recommendations 3
3. EXTENSA Findings and Recommendations 16
4. PODER Findings and Recommendations 32
5. Notes on Program Integration 45
Annex A List of Evaluation Sites 50
Annex B HOGASA Interview List 51
Annex C HOGASA Interview Guides 53
Annex D EXTENSA Interview List 56
Annex E EXTENSA Interview Guide 57
Annex F PODER Interview List
Annex G PODER Workshop Summaries
Annex H PODER Analytic Matrices
2
1. INTRODUCTION.
In September 2004, CARE Honduras hired an evaluation team1
 to conduct a final
qualitative evaluation of its Title II Food Security Program (FSP) implemented from FY 
2001 to 2005. CARE’s purpose for this evaluation is to measure impact and change as seen 
from the perspective of project participants. The findings of this qualitative evaluation are 
meant to complement those of the quantitative evaluation based upon a survey of 1800 
households in the project area.
1.1 Evaluation Goals and Methodology.
The evaluation team, comprised by an expert in sustainable agriculture and resource use, an 
expert in health and an expert in local governments, designed a field evaluation 
methodology based upon five broad questions of interest to CARE Honduras:
l What changes has the program brought about?
l What has been the magnitude of these changes?
l Who experienced or benefited from the changes?
l Will the changes last?
l What key (program promoted) processes have sustained the changes?
Taking these broad questions as a starting point, the evaluation team developed a set of 
intermediate level questions and themes to explore in the field, along with methods that 
would enable the team to elicit the views and opinions of project participants in an open 
and highly participatory manner.
Field investigation emphasized semi-structured in-depth interviews with participants and 
counterparts. Group interviews, observation of fields and homes, as well as workshops (in 
the case of PODER) complemented individual interviews. The team spent a total of eight 
days conducting interviews and workshops in project sites in the three departments where 
the FSP is implemented.2
1.2 Background.
The overall goal of the CARE Honduras Security Program is: 
 
1
 Kirsten Johnson has a Ph.D in small farmer resource management and has worked in rural 
development in Latin America, Asia and Africa for the past twenty years. Aida Maradiaga 
is a nutritionist who has worked for more that 10 years with the Ministry of Health. Nelson 
Mejia is a social anthropologist with 15 years experience working in Honduras.
2
 See Annex A for a list of sites.
3
“To improve, in a sustainable manner, the food security of vulnerable populations, at the 
household, regional and national levels, in the extremely poor municipalities of western and 
southern Honduras.”
The benchmarks measuring this goal include:
(i) Reduce indigent households in the target population by 20 percent;
(ii) Improve the caloric adequacy of target household food consumption by 10
percent; and
(iii) Reduce the rate of malnutrition in children 12 to 23 months by 30 percent in the 
target population.
The program’s strategic objectives are to:
(i) Increase availability of basic foods and high value crops in the most vulnerable 
households, communities and regions;
(ii) Increase access to nutritious food by those households which have a high degree 
of food insecurity;
(iii) Improve, in a sustainable manner, the biological utilization of food by the
project’s target population; and
(iv) Improve the institutional capacity of local governments and communities to plan 
and implement community development interventions and manage resources
devoted to improve livelihood and food security.3
CARE implements its FSP in the Departments of La Paz, Lempira and Intibuca, selected 
because of their high levels of poverty, infant malnutrition and food insecurity. 
To accomplish the overall goal, CARE carries out three separate, but complementary,
component projects: community health, agricultural extension and municipal capacity
building. Currently, CARE implements all three projects in 6o percent of program
communities; the remaining 40 percent of communities have at least two projects.
(i) Community Based Health Services Project (HOGASA). HOGASA’s main
objective is to improve access to and availability of health services by
establishing community based health centers (UCS) that provide volunteer
services to rural populations who are extremely vulnerable to malnutrition and 
infectious disease and where access to health services is extremely limited.
(ii) Food Security Extension Project (EXTENSA). EXTENSA’s main objective is to 
increase agricultural production and diversification by: training ‘model farmers’ 
(PPs) who, in turn, pass on their knowledge to other local farmers; channeling 
agricultural materials and equipment to farmers by means of community-based 
 
3
 The quantitative evaluation measures the benchmark and other indicators related to the 
overall goal and strategic objectives for the population in the program area. The present 
qualitative evaluation is meant to provide insights from the participant’s perspective. 
4
revolving banks; and by promoting appropriate technologies and practices such 
as agroforestry, soil conservation and low cost improved grain storage.
(iii) Rural Employment and Development (PODER). PODER’s main objective is to 
strengthen the capacity of local governments and civil society organizations to 
improve livelihood security by organizing at municipal and community levels, 
food security committees; providing food for work (FFW) opportunities
(improved roads, local markets, reforestation, rural housing, and cook stoves). 
2. HOGASA FINDINGS AND RECOMMENDATIONS.
2.1 Introduction.
CARE’s principal counterpart for HOGASA is the Ministry of Health whose staff provide 
health care services at either local health posts, Unidad Productora de Servicios, (UPS) or 
community-based centers. Unidad Comunitaria de Salud, (UCS). These facilities serve as 
food distribution centers and, in the case of the UCS, also as the community-based sites 
where Ministry of Health staff and CHVs provide health services and training for parents.
Three important changes were incorporated in the FY 2001-2005 design for HOGASA. The 
first was to change from an individual ration for malnourished children to a family food 
ration distributed to families with children age 6 to 23 months as well as pregnant women 
and mothers breastfeeding children under age 6.
The second change involved training CHVs in an expanded set of technical areas within the 
Integrated Management of Childhood Illness focus. HOGASA assimilated health
volunteers in health nutrition previously working within EXTENSA thereby tripling the 
total number of CHV in the program area.
The third change was to stop directing training and material resources towards traditional 
midwives and to focus efforts on the CHVs, a number of whom, in any case, are traditional 
midwives. 
Currently, HOGASA reaches 7137 beneficiary families with children under two years old, 
and/or pregnant or lactating mothers, located in 106 aldeas in 19 municipalities in the 
Departments of La Paz, Intibuca and La Esperanza. 
Selection of Sites and Interview Subjects. Site selection was done in coordination with 
CARE Honduras, however, the evaluator made the final choice of interview sites. 
HOGASA interviews were conducted in six municipalities, two in each of the program 
departments. One aldea was visited in each municipality. The choice of aldeas was based 
5
on three criteria: (i) include aldeas with UCS and without; (ii) accessibility; (iii) aldeas 
where HOGASA has been working for five years or more.4
Information for HOGASA was elicited from three different groups: mothers and fathers, 
health volunteers, and staff in local government health facilities. A total of 32 mothers and 
10 fathers were interviewed. All mothers, except for one pregnant woman, had children 
under two years old and were HOGASA participants. In the case of fathers, not all had 
children under two. A total of 13 CHVs, seven men and six women, were interviewed. All 
those interviewed are currently active in the CARE program. Two auxiliary nurses, sector 
medical chief and the technical assistant contact between CARE and the Health Ministry 
were interviewed for the counterpart perspective. 
Interview Methods. The evaluator used two techniques to gather information: (i) small 
group interviews; and (ii) individual interviews. 
Interviews were carried out in each of the municipalities visited with groups of mothers, 
fathers and health volunteers who had been convened by CARE staff. Interviews were 
conducted in community facilities such as UCSs, churches, schools, or, in some cases, 
private homes. Non-participating community members and CARE staff were excluded 
from the interviews in order to allow those interviewed to feel that they could express their 
opinions freely. 
Groups were comprised of four to five people. The evaluator both facilitated the dialogue 
and recorded the responses. Some groups were comprised of all women and others all men, 
and yet others were mixed women and men. The purpose was to ascertain whether mothers 
would express different opinions when they were alone than when they were in the
presence of men. A total of four group interviews were conducted with mothers, two with a 
mixed group of mothers and fathers, one with fathers and three with health volunteers.
Individual interviews were conducted with women to ascertain whether they would express 
different opinions alone than when they were interviewed in a group setting. At the same 
time the evaluator took the opportunity to observe how children were taken care of in the 
mother’s home. A total of four individual interviews were conducted with mothers and one 
with a health volunteer. Interviews with government health staff were all individual,
sometimes conducted in their offices and sometimes in their homes, on their days off. 
An interview guide, containing key themes of interest, was developed for each of the three 
groups, both for group and individual interviews. 5
 The interviews were open-ended, semi￾structured conversations wherein the evaluator followed through on particular topics,
depending on the flow of the dialogue.
2. 2 Have things changed?
 
4
 See Annex B for a list of the aldeas where HOGASA interviews were conducted and the 
names of persons who participated in the interviews.
5
 See Annex C for HOGASA interview guides.
6
Fewer undernourished children. Reduction in the number of malnourished children is one 
of the achievements mentioned by most fathers and mothers. Parents think that while there 
still may be malnourished children, these are now fewer than before. Others mention that 
when children are sick they lose weight but that they recover it because parents now know 
how to care for them better, especially
concerning their feeding, when they are ill.
Mothers say that they know when their
children are not undernourished when they 
are weighed and they see that they are
gaining weight. Two mothers were of the 
opinion that the fact that pregnant women 
are receiving food assistance helps their
babies to be born well nourished and
“pretty.” Yet two mothers said that the majority of children are malnourished because they 
get sick a lot and, because of a lack of food, there are few days in which children are 
healthy “alentados.” Despite this, one of them said that before there were many more
undernourished children. As far as illnesses, fathers and mothers report that these always 
happen but that the severity is less because children are attended to sooner.
Health volunteers and government health workers also state that there has been a reduction 
in overall malnutrition, especially its severe forms and that child growth rates have
improved. One of the volunteers said that they had almost reached their target since the 
majority of children are now gaining weight. Some volunteers are of the opinion that, 
although there are still malnourished children, this is because there are mothers who do not 
take care of them and do not follow their advice. 
One government health worker stated that nutritional problems continue in the area and that 
there is no difference between 1996 and the present and that the difference between
program and non-program communities is only about three to four percent. However, this 
worker thinks that this might be because CARE works in the poorest communities. 
Lower infant mortality. Government health workers and some volunteers and parents
report that, in recent years, there has been a decline in infant mortality among children 
under five. The auxiliary nurse in Guajiquiro stated that before HOGASA an average of 
five children under five died. Last year only one died. Government health workers also 
confirm that mortality rates among mothers have gone down. 
“Before, children were killed by diarrhea, nausea (vomiting). Now the mothers have their children 
there; they don’t die. They still do die in the womb, or during childbirth. That hasn’t changed 
much.”
A mother in Aldea Semane, Mpio Yamaranguila
“Eight years ago, there were more malnourished 
children because when we took them to their doctor 
appointments we did not receive any education; now 
they explain to us about nourishment and the children 
are less malnourished.”
A mother, Aldea Sta Lucia, Mpio Santa Ana
7
Lower infant mortality is a high priority for CHVs. One volunteer reported that the
government health workers have told him/her that infant mortality has declined because of 
the work the volunteers are doing. And one mother stated that before more children died 
because they did not have CARE’s help.
Health services are closer. Another of the changes noted by parents is that health services 
for children under two are much closer now, something they consider very beneficial.
Parents believe that this has contributed considerably to a reduction in infant mortality.
Despite the fact that parents state that their children always get sick, they greatly appreciate 
the presence of a health volunteer who has medication to treat pneumonia and diarrhea and 
who has an elementary knowledge of these illnesses. This means that parents do not have 
to travel great distances to find medical attention and it also means that they get earlier 
assistance for their children thereby reducing the probability that the child will become very 
sick or die.
“Our commitment is to not let children die. This year no child has died. Only in childbirth do 
some die. There used to be many deaths due to pneumonia; now it is cared for in the 
community, and if it is very bad we send it to the doctor.”
A health volunteer, Aldea San Jose, Mpio San Marcos de la Sierra
“There used to be many deaths due to pneumonia; now it is cared for in the community. If it is 
very bad we send it to the doctor.”
A health volunteer, Aldea Quezungual, Mpio Gualcince
8
All parents interviewed stated that when their children are sick they first go to the health 
volunteer who not only provides medicines but also advice as to how to care for children 
and how to feed them. 
Some government health workers also report that the number of diarrhea cases has gone 
down since many are being treated by CHVs who give parents advice on how to prevent 
this problem. As for pneumonia, according to the mothers, there is still the same number of 
cases, but their children do not become so ill since they are seen sooner.
Government health workers say that with the help of CARE’s program, mothers go to the 
health centers on a more regular basis for prenatal check-ups, vaccinations and growth 
monitoring. One of the nurses mentioned that in her health center they now see more 
pregnant women before their second trimester than they did previously.
Another of the services that is appreciated by 
parents is monthly growth monitoring of their 
children, an activity carried out by volunteers 
when mothers in the neighborhood bring their 
children to be weighed and to receive advice 
on the care and feeding of children according 
to their age group. Generally, the auxiliary
nurse of the health center also attends these sessions.
Mothers speak about the health volunteers
“Eight years ago it was more difficult; we used to go to the health center in Guajiquiro. It used to take us two 
hours’ walking, and now we go to the volunteer right there in the village.”
Aldea Ingrula, Mpio Guajiquiro
“Eight years ago we used to go to Yamaranguila, hours on foot, because there was no health center or 
volunteers.”
Aldea Semane, Mpio Yamaranguila
“There are always diseases, but we are fortunate because there are volunteers in the communities; they have 
medicines and, if it is something serious, they refer it to the health center.”
Aldea San Jose, Mpio San Marcos de la Sierra
“With my older children I suffered a lot; they became gravely ill from pneumonia, their little chest and ribs 
would jump, but now with the little ones I haven’t had that problem.”
Aldea La Arada, Mpio Candelaria
“In the card we see that the child gains weight; 
they demand that the weighing be monthly. It is 
an advance for us.” 
A father, Aldea La Arada, Candelaria
9
Many parents like to know that their children are gaining weight, which for them is a sign 
that they are not malnourished. In addition they appreciate the fact that when their child is 
not gaining weight, the volunteer provides advice on how to care for her so that she will 
recover. 
Parents know more about how to feed and care for their children. CHVs’ educational 
activities are oriented to promoting the adoption of adequate hygiene, breastfeeding,
weaning practices, as well as the care of sick children and reproductive health. Those 
interviewed reported that one of the gains of the project is that they have acquired more 
information about how to feed and take care of their children from the health volunteers. 
Parents consider this activity as a key contribution to their children’s improved health and 
nutrition. Parents report that the most significant changes as far as the practices being
promoted are those related to hygiene, in particular, hand washing before meals, bathing 
and the use of clean clothing. In addition, they report that they keep their homes cleaner 
and, as one father said, they teach their children to live better.
Parents state that there have also been changes in weaning practices, including:
² Mothers grind and mash foods, such as beans, before giving it to their small
children; before, children would be given whole beans and other foodstuffs that had 
not been broken up into smaller pieces;
² A few mothers mention that they feed their small children at more frequent
intervals;
Parents talk about improved hygiene 
 “Now everything is more orderly because the children don’t eat on the floor any more; they are given their food with 
a little teaspoon.” 
A father, Aldea Santa Lucia, Mpio Santa Ana
“One doesn’t live like in the city, well-polished, but we don’t live as we used to; we have a change of lifestyle, not 
disordered as it used to be; the chickens used to sleep in the same place as the people, now we have a henhouse, we 
sweep the house twice a day.”
A mother, Aldea Semane, Mpio Yamaranguila
“Previously we lived without cleanliness, by God’s Hill; we were not careful, we didn’t care about the flies, we still 
have problems but I have observed changes.”
A father, Aldea Semane, Mpio Yamaranguila
10
² Weaning is delayed until children are six months old; before, weaning began at 
three to four months; 
² Mothers vary children’s diet a little more, giving them a little more fruit, vegetables 
yucca and donated food;
² They prepare a thick soup of beans, using ground up beans instead of just the water 
that beans were cooked in; 
² Some mothers also mention that they now set aside time to take care of their child 
when s/he eats. Some fathers say that they also help feed children when they are at 
home; 
² All mothers mention that they include donated foods, including CSB, in their 
children’s meals. 
Parents think that HOGASA’a recommendations are very useful because they are easy they 
have seen that their children are doing better. Parents state that they will continue to do the 
practices 
A smaller number of mothers also report that they now space their pregnancies and do not 
have as many children as before.
Health volunteers agree that mothers have adopted hygiene practices, feed and care for their 
sick children, keep their homes swept and their children clean. One of the CHVs stated that 
mothers no longer give children aceite de zorrillo for coughs nor do they use alcohol for 
their children’s fevers. 
Some fathers participate in HOGASA sponsored educational activities, especially when 
they accompany their wives to food distributions. However, most fathers do not attend 
these activities because, as they state, they are busy at work and do not have time for such 
things. In most communities, health education has focused mostly on mothers. Of the 
fathers who were interviewed, only a few had attended educational sessions. However, in 
some communities there has been more of an effort to find the times to involve fathers in 
educational activities, for example, with men who participate in the FFW roads projects, in 
patronato meetings, or when men arrive for food distribution. 
Some parents state that husbands help their wives in childcare and housekeeping, especially 
sweeping, or taking care of children when the mother is out. Some men said that many of 
them feel ashamed if someone sees them doing housework. Although gender roles still 
prevail, (As one mother put it, “The fathers are of the fields, the mother is the one who 
remains with the children.”) some mothers think that men now help around the house more 
than they did before.
11
Better housing. Although this activity is sponsored by PODER, it was mentioned by a 
small number of parents who think that it is a very important aspect of family health
because it reduces the risk of illnesses transmitted by insects. Parents consider that 
more solid roofing has been particularly important.
Some health volunteers think that it is necessary to include a latrine program since many 
homes do not have one and this means that there is a continued risk of pollution. Others 
suggest that the home improvement activities should be expanded to reach more families. 
2.3 Who Benefits?
HOGASA targets families with children under two years, pregnant women, or mothers who 
breastfeed. All those interviewed stated that almost 100 percent of families in this category 
are receiving attention and advice from CHVs, as well as donated food. A few families do 
not receive food assistance because they do not want it; others because they have missed an 
appointment at the health center. However, once they do make their appointment, then food 
assistance is renewed. 
Those interviewed think that the project’s main beneficiaries are the children. However, 
they also state that the whole family also benefits, especially mothers who now have better 
knowledge about childcare. Not one of the parents interviewed said that a CHV has denied 
them attention. 
2.4 What processes have sustained changes and benefits?
The CHV network. Parents consider that the work that health volunteers do in communities 
is very important and has made a real difference in their children’s health. Parents report 
that the volunteers will come to their home when their children are ill, that the CHV holds 
monthly meetings where children under two are weighed and their growth is tracked and 
where the volunteer gives them advice and talks about different topics related to childcare. 
Parents value this information and say that they put it into practice at home because it has 
proven effective. 
One of the advantages mentioned by parents is that the CHV is always available, whether 
it’s day or night, a weekday or weekend, or holiday. This is not the case with the health 
posts. 
“There are no more little houses of straw; there is no danger of chinche picuda (Chagas bug); the children 
no longer play in the dirt, and there aren’t as many fleas in the house.”
A father, Aldea Semane, Yamaranguila
12
CHVs all state that they feel great satisfaction in the work they do, despite the fact that they 
do not get a salary. They believe that their work is valuable and are willing to help families 
who need them even if it is nighttime. As one volunteer put it: “When one sends a person 
with a referral, one saves their life.”
According to the CHVs who were interviewed, the incentives they find in their work is the 
knowledge they gain as a result of the training they receive; the fact that they feel useful 
and important when they are sought out by parents with sick children; and the recognition 
they win in their communities. Government health workers value the contributions made 
by CHVs to maternal child health care. They
also give priority to the cases CHVs refer to
them and provide them with information on
follow-up. All these elements, make health
volunteers respected leaders in their
communities.
Some CHVs, especially younger ones, would
like to have more training so that they can
attend other community health needs, such as first aid and other types of illnesses.
One important point mentioned by CHVs is that, thanks to CARE’s program, the number of 
volunteers has increased from the original one per community to two to four. CHVs say 
that they now receive more training through the project than than CHVs who only work 
with the Ministry of Health. 
Some Health Ministry staff stated that the CHVs in HOGASA have received much more 
training and supervision than those who are not. CHVs working in CARE’s program also 
receive other incentives such as: backpacks, caps, flashlights, and when they attend
trainings CHVs are given meals. They also are provided with much more educational
materials, especially in nutrition than the CHVs working only with the Ministry of Health. 
CHVs state that one of the difficulties they encounter is when a volunteer withdraws from 
the program, thereby greatly increasing the workload of those who remain. However, they 
“Eight years ago there were no people in the community to orientate us about hygiene, which is the 
base for the healthy growth of the children.”
A mother, Aldea Ingrula, Mpio Guajiquiro
 “We are lucky because we have a volunteer in the community.” 
A mother, Aldea Sta. Lucia, Mpio Santa Ana
“We like that we are sought out by other 
institutions to ask us for information; we feel 
important, we feel ‘black tie’.”
A health volunteer, Aldea Quezungual, 
Mpio Gualcince
13
do not find that, under normal circumstances, their work as volunteers is too time
consuming.
CHVs say they do have problems when they run out of medicines. Another issue for them 
is that volunteers are not reimbursed for travel expenses when they attend Ministry of
Health sponsored training sessions.
Food Assistance. All parents, CHVs, and government health workers agree that donated 
food is the main factor in improved child nutrition. Most state that in the absence of food 
rations, children would have less to eat and that malnutrition rates would go up.
Food rations are used for household consumption. Although there were some initial
problems with CSB and oil, those interviewed report that after the training they have
received, they now know how to prepare the food ways that most families accept. Mothers 
say they now prefer the oil they get from the program to the lard they used to eat.
Nonetheless, in some cases, some of those interviewed mentioned that some donated food 
is sold, primarily for cash to buy other foodstuffs such as bread or sugar.
Donated food contributes in an indirect way to improve and diversify households’ diets 
since, as parents explain, they do not have to buy staple foods such as rice and beans and 
can use their scarce cash to buy other products such as vegetables, pasta, chicken or meat at 
least once a week. Some fathers also report that they can now also use the money they do 
not spend on food to buy fertilizer.
Government health workers use food as a way to make families attend health centers for 
vaccinations, growth monitoring, and prenatal care. When families do not make their
appointments, then they are told that their rations may be cut. This usually ensures full 
attendance.
2.5 Will the changes last?
It is vitally important to development agencies to have the processes that have been
promoted at the community level to sustain themselves over time. Therefore, the views of 
those who are directly involved in these processes about their future, provide useful insights 
into the prospects of sustainable change.
Everybody recognizes that food assistance is a key element in CARE’s maternal child 
health care program. Almost all those interviewed think that without donated foods, the 
changes promoted by HOGASA will falter and that there will be a return to the situation 
before the program when families, especially children, had less to eat.
Parents state that household incomes are too low to be able to buy the same amount of 
foodstuffs, especially rice, which to them is a highly valued and much accepted food,
especially by children. Other parents state that people are too lazy or that there isn’t 
enough rain for more than sparse and uncertain harvests.
14
Some mothers and government health workers think that if there is no food assistance 
mothers will no longer attend meetings at the health posts nor will they bring their children 
in for growth monitoring since they will not think them worthwhile. Only one of the 
groups (with both mothers and fathers) interviewed think that if food assistance ends, they 
would find a way to make up the difference. 
CHVs and government health workers 
also think that food assistance is a
necessity for families because the
limited resources in the communities
mean that families will not be able to 
make up the difference once food
assistance is withdrawn. One nurse
reported that health workers have been 
raising awareness among people that food assistance is temporary, however, families are 
very dependent on food donations so they will be missed.
CHV networks. Most of those interviewed thought that the community-based health
volunteer system has a good chance of continuing after CARE withdraws. Parents state that 
they would like it to continue because it is very beneficial and that they would support the 
volunteers and seek support for them from the Ministry of Health. Other mothers state that 
they will help their CHVs by attending their meetings and not criticizing them. Some 
fathers think that the CHVs will continue working but they will receive less support and 
that the government should give them an economic incentive.
CHVs also think that they will continue their work in the same manner even if CARE is no 
longer present. However, some think that in the absence of food assistance, mothers will 
Mothers speak about the end of food assistance
“People are accustomed to that food. If it were taken away, it will be felt in the children. It might be 
purchased, but it would be more costly. There would be more suffering and they would have to work more.” 
Aldea Sta Lucia, Mpio Santa Ana
“I think it is sad that they leave. Some days we would get food and other days we would not. There is no 
work and there is no money.” Aldea Semane, Mpio Yamaranguila
“We would be left like before. We wouldn’t eat rice. The money isn’t enough to buy it because we also have to 
buy manure. If we don’t lay manure, there is no harvest.” 
Aldea Semane, Mpio Yamaranguila
“For everyone it is better that the institutions remain, that if only they wouldn’t leave so we don’t have the 
children like before, not keep suffering. Where are we going to go to ask, that they never leave.” Aldea 
Semane, Mpio Yamaranguila
A minority opinion
“The children are not going to return to what was, we 
have to live as if HOGASA always were there, that the 
children do not lack food, that they keep growing.”
A father, Aldea La Arada, Candelaria
15
no longer come to have their children weighed. Other volunteers think that the Ministry of 
Health supports them, values their work and provides them with the medicines they need.
The head of the Marcala health district report that the Ministry of Health is replicating the 
HOGASA model in four communities, three of which receive food assistance and one that 
does not. In this community mothers are bringing their children to checkups and to be 
weighed. The municipality has fixed up a center and two other mayors are requesting UCS 
for their communities, offering to build and maintain the necessary buildings. These
examples provide some insights into the possible sustainability of project sponsored
changes. 
2.6 Conclusions and Recommendations.
Conclusion 1. The great majority of parents, community health volunteers (CHVs) and 
government health workers interviewed, state that there have been positive changes in the 
health and nutrition situation of mothers and infants. Moreover, they identify other
changes, such as greater knowledge among mothers about the care of their children, greater 
access to health services and improved 
dwellings, leading to better overall family 
health and nutrition. In the minds of those 
interviewed, these changes can be directly 
attributed to CARE’s program. 
Changes in child care practices are
focused primarily on personal hygiene,
clean food preparation, and clean
dwellings. In addition, exclusive breast feeding until six months, and appropriate weaning 
food preparation, such as soft foods and more frequent feedings, are seen to have
contributed to healthier babies.
Recommendation 1. CARE should continue with its current approach to community health 
outreach since it has been able to bring health services closer to populations that are the 
most distant from health centers and, moreover, beneficiaries consider these services to be 
important and are satisfied with the results.
Trainings given to mothers on food preparation, especially in communities where the
program is close to leaving, should put more emphasis on recipes using local foodstuff and 
less on donates foods, since the latter will be available for only a short time.
Conclusion 2. HOGASA beneficiaries are families with children under two, pregnant
women and breastfeeding mothers. In the program communities nearly 100 percent of
qualifying families participate in HOGASA. Those interviewed report that children are the 
main beneficiaries, but also say that women benefit since mothers have acquired new
knowledge about childcare. 
“Eight years ago there were more malnourished children 
because when we took them to their doctor appointments 
we did not receive any education; now they explain to us 
about nourishment and the children are less 
malnourished.”
A mother, Aldea Ingrula, Mpio Guajiquiro
16
Recommendation 2. HOGASA should continue to target mothers and children under two, 
given that these are the groups that are most vulnerable to malnutrition. CARE should 
reinforce its messages in reproductive health, given that changes in this area are
mentioned less frequently by participants.
Conclusion 3. Participants identify food assistance and a system of health attention based 
on health volunteers as the two most important elements in the program since these have 
brought about improvements in their children’s health and nutrition. Opportune attention 
and health messages parents receive from the health volunteers contribute to more rapid 
recovery from illnesses and a reduction in deaths. Donated food means that parents can 
feed their children better and improve their nutritional status.
Recommendation 3. CARE should continue its trainings and support for health volunteers 
in order to strengthen their technical capabilities. Training is also one of the main
incentives for health volunteers to participate in the project. CARE should consider
expanding the volunteers’ trainings to include other topics in community health care.
Conclusion 4. All those interviewed consider that, given low incomes and inadequate 
agricultural yields in the project area, not 
all households will be able to achieve food 
self-sufficiency without food donations
provided by the program. Food assistance 
is considered indispensable to maintain
adequate child nutrition. The overall
message from parents, health volunteers
and government health workers is that CARE not leave the region. 
Recommendation 4. CARE should strengthen efforts to promote income generation and 
food production, involving as many families as possible, in particular, the poorest
households. 
Conclusion 5. Those interviewed believe that the community health service based on health 
volunteers as sustainable, even without CARE presence. However, they think that health 
volunteers need active community and Health Ministry support in order to continue.
Parents state that they plan to support their health volunteers by continuing to attend
meetings, providing moral support and not criticizing them.
Recommendation 5. CARE should ensure Health Ministry and community support for the 
community-based health model. Continued trainings, supervision and training materials 
are particularly important in this regard. It would be useful for CARE to include a module 
on the right to health care in HOGASA training, so that parents and volunteers are more 
informed as to what they can demand from government health services.
“We see no possibility in the near future that we will not 
need foodstuffs. The harvest is not attained.”
A father, Aldea Semane, Mpio Yamaranguila
17
Conclusion 6. The evaluator was unable to find very much of a linkage between HOGASA 
and the activities of the other two projects in CARE’s Food Security Program. For
example, households with children under two are not involved to any great extent in food 
production, nor do they receive support from organizations working with PODER. 
Recommendation 6. Activities of the three component projects should be more integrated 
at the community level. Families with children under two should be included in EXTENSA 
food production activities, thereby benefiting this vulnerable group. PODER should also 
work with and provide more support to health groups. 
3. EXTENSA FINDINGS AND RECOMMENDATIONS.
3.1 Introduction.
 
EXTENSA’s main goal has remained consistent over the ten year period spanning its first 
and second FSP planning cycles: to increase food availability by promoting increased
agricultural crop diversification and productivity. EXTENSA does this by (i) training
‘model’ farmers who establish demonstration plots and teach other farmers about crop
diversification, agroforestry and soil conservation techniques; (ii) providing agricultural
inputs (tools, improved variety seeds and fruit saplings, chemical fertilizers, irrigation
materials and equipment) by means of a community based revolving credit system; (iii) 
helping participants establish drip micro-irrigation systems; (iv) promoting appropriate
technologies such as grain storage silos and (on a pilot basis) solar cookers, solar-powered 
pumps, solar driers, and household rainwater harvesting; and (v) advising farmer groups on 
marketing farm surplus.
Currently, EXTENSA works in 19 municipalities, 84 aldeas (villages) with 3400 in the 
departments of La Paz, Intibuca and Lempira. The majority (92%) of project participants 
are male heads of household. Some farmers have participated in EXTENSA activities since 
the first FSP DAP began in 1996; others have joined more recently. 
Selection of Sites and Interview Subjects. Site selection was done by the evaluators in 
coordination with CARE Honduras. CARE wanted interviews conducted in sites in all three 
departments where the FSP operates. Given that this is a large, often poorly
communicated, area and the allotted field research time was limited to six days, it was 
imperative that the evaluation team select sites with an eye to time and logistical efficiency, 
as well as build in an element of randomness. Moreover, the choice of aldeas for
EXTENSA needed to reflect a range of geographic conditions (resources, elevation, access 
to markets) characteristic of the diverse conditions within which EXTENSA operates. The 
evaluator made the final choice of six aldeas in six municipalities (two each for the three 
departments) reflecting all the above criteria and constraints. 
18
The interview subjects of most interest to EXTENSA were: ‘model’ farmers (Productores 
Promotores), ‘student’ farmers affiliated to EXTENSA’s revolving fund banks (BRHIS), 
their wives, and farmers in same aldea who are not members of the EXTENSA group. In 
all, the evaluator conducted 18 individual and 6 small group interviews and visited farmer 
plots and BRHIS storeroom/meeting rooms in all six aldeas. 
6
 It should be stressed that the 
information derived from these interviews is illustrative and detailed, but by no means
representative of the entire EXTENSA participant population.
Interview Methods. The SOW calls for an evaluation of change and impact as seen through 
the eyes of the FYP’s principal beneficiaries. Thus the purpose of the field methodology 
was to place an emphasis on the perceptions and stated views of EXTENSA’s participants. 
The objective of the interview was to establish a fluid dialogue on the basis of a semi￾structured, open-ended question format and record the result in the most direct, verbatim 
manner possible. 
Most of the interviews were in-depth, one on one exchanges lasting between 45 minutes to 
two hours and were complemented by visits to the farmer’s field where follow-up questions 
were made depending on topics observed in the setting. Group interviews were conducted 
with three to four participants in BRHIS storerooms and focused primarily upon their views 
on the effectiveness of their revolving banks. 
Interviews were organized around themes judged to be measures of change significant in 
participants’ own terms. These include: (i) perceived changes and improvements in
production, access to inputs, farm assets, income and household wellbeing; (ii) equitable 
return for effort and distribution of benefits and risks; (iii) sustainability of changes and 
benefits.
For the purpose of structuring the flow of an open-ended interview format, these themes 
were expressed in terms of simple ‘generative’ questions and their respective follow-on 
question sequences. Care was taken to avoid leading questions and to trigger an open ended 
dialogue, rich in detail and narrative that spoke to issues of change, equity and
sustainability in terms that are real and significant to those being interviewed. 7
3.2 Have things changed?
When asked whether they are doing things now that they did not do five to eight years ago, 
farmers almost uniformly state that, indeed, they are doing things differently and that 
 
6
 See Annex D for a list of aldeas and individuals who were interviewed for EXTENSA.
7
 See Annex E for the EXTENSA interview guide.
“Before they threw the grass away and burned it. Now nobody does that because it is forbidden. Now we 
can have trees, mango, orange, avocado trees. We eat them and we will sell them when there are more.” 
(smiles) 
Jose Felix Echeverria Aldea Gualcea, Mpio Gualc ince
19
EXTENSA has been instrumental in changing their agricultural practices and farm assets. 
Farmers readily described numerous, vivid examples and gladly displayed these to the
evaluator in their gardens and fields. 
Perhaps the most widespread changes in agricultural practices result from EXTENSA
farmers’ decision avoid the traditional practice of burning weeds and crop residues in their 
fields before planting. Farmers who no longer burn their fields, can deploy a range of 
alternative management techniques that enhance soil fertility and humidity. This, in turn, 
leads to higher yields and more secure harvests. When farmers stop burning their fields 
they are also able to invest in higher value perennial tree crops, protected woodlots,
windbreaks and fishponds. 
EXTENSA farmers typically adopt hillslope soil conservation measures such as dead and 
live barriers and infiltration ditches. They practice contour planting and, in some instances, 
minimum tillage. They grow high value fodder grasses, pineapples and izote palms along 
contours as live barriers. They erect live fences to protect their fields from livestock and 
then establish plots blending a wide variety of annuals (corn, beans, yucca, malanga, 
potatoes, vegetables) with perennials and subsistence with commercial crops in
agroforestry configurations suited to their particular elevation and rainfall conditions.8
Farmers report planting a large number of high value, grafted fruit saplings and perennials 
including: mangoes, oranges, lemons, grapefruits, tangerines, apples, peaches, bananas,
coffee, cacao, avocados, coconuts, pineapples, papayas, nances, jocote and marañon. 
Farmers enhance their investment by planting saplings in small, well-spaced, individual 
terraces with organic fertilizer. Saplings observed by the evaluator were weeded and pruned 
and free of insect pests and disease. 
Two things that traditional field burning accomplish is to control weeds and to provide 
plants with nutrients derived from ashes. Farmers who stop burning must find alternative 
ways to rid their fields of weeds and enhance soil fertility. EXTENSA farmers resort to 
different approaches, some capital intensive and others labor intensive. Some farmers
prepare their own organic fertilizer. Others use chemical fertilizers. Others do both.
 
8
 The FSP area is quite diverse in elevation and rainfall. Higher area farmers tend to grow 
more vegetables than farmers in lower, hotter areas who, on the average, grow a greater 
variety of fruit species. 
“Look, now I have stone and wooden barriers. I make curves with my A level. I have irrigation channels
and live barriers of valerian grass, pineapple, and izote, which they come to buy from me from San Pedro. 
I make compost heaps and bocash manure. I don’t cut the grass anymore and I don’t burn the stubble. I 
have my drip irrigation for my fruit trees and for the vegetables. I planted new varieties of bananas, 
mangoes, and lemons. I have yucca and plant tomato, bell pepper, and onions. Now, every year my soil is 
improving. Not like before.” 
Pedro Vazquez Aldea Semane, Mpio de Yamaranguila
20
Most EXTENSA farmers now use chemical fertilizers for their grain crops such as maize 
and beans. Farmers also incorporate crop residues and other organic material that would 
otherwise have been burned into the soil. Some farmers make organic fertilizer and apply it 
on their high value crops or use it in seedbeds. Shade provided by the canopies of
agroforestry plots tends to cut down somewhat on weeds. However, farmers now must 
invest more time in hand weeding their field crops. Others report using herbicides such as 
gramoxone and 2,4-D.9
 
In addition to improved rainfed farming systems, EXTENSA farmers with access to local 
water sources have been able to introduce drip micro irrigation systems used primarily for 
high value, marketable vegetables The evaluator observed a variety of vegetables, including 
cabbage, onions, lettuce, radishes, green beans, chilies, potatoes and flowers being grown 
with drip irrigation systems. Farmers also report growing melons, watermelons and
tomatoes. Drip irrigation is also important for growing certain fruit trees. Greater water 
availability also allows some farmers to build small fishponds and raise tilapia. 
The great majority of farmers who were interviewed associate their new farming practices 
and improved farm assets with larger harvests (mainly of maize and beans, but also
vegetables and potatoes) and the potential to grow a greater variety of new crops for home 
consumption or sale. As will be described in more detail in the section below, farmers 
believe that increased production of basic grains, along with diversification into cash crops, 
is translating into significant changes in their household livelihoods. 
All farmers state that these livelihood improvements were made possible new knowledge 
provided by CARE field staff and also by access to inputs (improved seed varieties, high 
quality saplings, chemical fertilizer, tools, irrigation equipment) made available by their
local revolving credit banks, the BRHIS. 
 
9
 Farmers also say they use parathion to control leaf-cutter ants. It should be noted that 
CARE does not provide or promote the use of pesticides or herbicides.
Two Views from Aldea San Jose, Mpio Guajiquiro
“Chemical fertilizers are very expensive. It is better to use organic ones produced here. It is better 
for the soil. It is better for the plant. It is healthier and more inexpensive. I prepare compost heaps 
with animal manure.”
Antonio Sanchez Gomez
“CARE gave us chemical fertilizer and urea as an incentive. The partners of the BRHIS revolving 
fund bank appreciate it more and are more motivated. We learned that corn needs more chemical 
fertilizer and we learned to use more. The BRHIS revolving fund bank buys large quantities and 
then the partners take out loans.”
Luis Hernandez Gomez 
21
About one third of those interviewed report that they have had contact with other rural 
development organizations and thereby were somewhat familiar with a number of the
practices promoted by EXTENSA. Nevertheless, most farmers state that EXTENSA’s
trainings and extension advice have been worthwhile and that CARE extensionist’s
recommendations have been widely adopted by EXTENSA participants. People find this to 
be the case both in terms of agricultural practices as well as those dealing with group 
organization and BRHIS administration. 
All persons interviewed stated that rural credit of the type afforded by the BRHIS
associations is simply unavailable to small farmers. Everyone interviewed had taken out at 
least one loan from their banks; most members had taken out and repaid three to four loans. 
The availability of key production inputs on fair terms has made it possible to implement 
EXTENSA field staff recommendations.
3.3 How significant have these changes been?
The majority of those interviewed state that they have experienced very significant changes
in their farming practices, their assets and harvests and wellbeing. The pivotal change has 
been their decision to take the necessary steps to intensify their production systems and to 
risk debt in order to increase farm assets and (for some) to grow new cash crops. 
Rainfed agroforestry plots established on hillslopes with soil conservation structures, and a 
diverse mix of annual crops and improved variety fruit trees represent important 
investments both in terms of agro-ecological knowledge and farm assets. Drip micro
irrigation systems have opened a range of new possibilities for market production as well as 
home consumption. When they have access to markets or to local buyers, EXTENSA
farmers who grow vegetables and potatoes on small, irrigated plots have been able to boost 
their cash income sufficiently in order to cover both their loans and basic household
requirements. 
Very significantly, a dramatic increase in chemical fertilizer use, coupled with the adoption 
of high yield varieties of maize and beans, has made many farmers largely self-sufficient in 
maize and, to some extent, in beans. Some farmers report that they are now able to sell 
maize and beans. 
“Yes, I’ve taken loans out from the bank: tools and vinyl pipe and improved seeds. It is good because 
payment is in installments. It is excellent because it is a bank in the community and we manage it 
ourselves. We also provide a service of purchase (not in installments) to others who aren’t members.” 
Jose Maria Vazquez Aldea Semane, Mpio Yamaranguila
22
Many farmers now have planted between one dozen to two dozen high value fruit saplings 
(some have planted up to 40). Production for most of these tree crops is between two to five 
years away, thus, in a sense, significant returns are yet to materialize. Nevertheless, all 
saplings observed by the evaluator were located in protected agroforestry plots or located 
close to homesteads, a sign that farmers value their new assets and have high expectations 
for good returns on their investments. In the short term, farmers now are able to harvest 
products, such as grasses (for fodder) and pineapples, from live barriers established at the 
outset of the project. 
Another significant change is related to group experiences with revolving bank
associations. Although group cohesion and success with loan repayments vary across
23
banks, the farmers interviewed were uniformly positive about this form of credit and the 
possibilities afforded them to access key inputs. Many consider their BRHIS to be the 
crucial element in EXTENSA. 
According to participants and (the few) spouses interviewed, changes in production and 
income have resulted in improved family wellbeing. Most frequently mentioned are: (i) 
maize self-sufficiency means that family members no longer need to seek off-farm work; 
(ii) surplus maize and beans are sold to cover the cost of fertilizer and also household cash 
needs; (iii) vegetables and fruits are consumed by children and other family members (the 
EXTENSA farmers talk about their crop yields
“Now we produce more (than five years ago) through staggered crops. We have crops of potatoes, kidney beans, lettuce, and cabbage, 
and other vegetables.” 
Luis Hernandez Gomez Aldea San Jose Mpio Guajiquiro
“In a good year, we have corn enough for expenses. It depends on the rain. But before, life was tighter.”
Evaristo Vazquez Aldea Sta Lucia Mpio Sta Ana
“In good years we have enough, on others we don’t. It was more complicated, five years ago. We used to harvest less because there was 
no fertilizer.”
Jose Ernesto Vazquez Aldea Sta Lucia Mpio Sta Ana
“Before the harvest wasn’t enough because we didn’t have fertilizer. Now it does. Because of the loans of the BRHIS.”
Martin Sanchez Aldea Sta Lucia Mpio Sta Ana
“We don’t buy fruits, tubers for our consumption. Corn, up to a certain point. It lasts us between eight and twelve months. It depends 
on the winter. We sell malanga, plantain, yucca to buy corn and beans that we need. Before, we could hardly get our produce out 
because there were no roads. Now we can, because of PODER. Before, we sold the best and ate the worst. Now we eat the best. I no 
longer have to go out to do journey-work. ”
Pedro Vazquez Aldea Semane Mpio Yamaranguila
“Yes, I produce everything my family needs for the year: corn, beans, pineapple, chayote, yam, yucca, oranges, coffee, and plantain. I 
used to sell coffee to buy corn and beans. I don’t go out to do journey-work as I used to.”
Jose Ma Vazquez Aldea Semane Mpio Yamaranguila 
“No, we don’t have enough for more than five months. But before it used to be worse. I sell pineapple from my live barriers.”
Cristobal Pineda Aldea San Jose, Caserio El Horno, Mpio San Marcos Sierra
“Having the harvest suffice for the whole year is difficult. But now I have silos and I sell them. I took a course in EXTENSA and I 
learned to make them. Now I’ve sold about 600 silos that PROSOP Project buys from me.”
Ramiro Gomez Aldea San Jose, Caserio El Horno, Mpio San Marcos Sierra
“It doesn’t suffice for the whole year. Corn and beans do, but not sorghum. Eight years ago it was worse. The corn didn’t suffice and 
beans were scarce, and we had to buy. My wife sold chickens and pigs and I used to go do journey-work.”
Alejandro Cantarero Aldea San Francisco Mpio Candelaria
“It’s been two years now that I haven’t had to buy corn. I have enough. Before, corn was very scarce. I used to do needlework to earn 
some money so I could buy corn and beans.”
Fermina Garcia Aldea San Francisco, Mpio Candelaria
“Now I harvest enough. I don’t buy but neither do I sell. Corn used to last only five months. I used to do journey-work near here.”
Jose Felix Echeverria Aldea Gualcea Mpio Gualcince
“Yes, now I harvest about 50 quintals of corn for consumption. I also sell corn, sorghum, and beans. I used to only harvest for 
sustenance and I had to go do journey-work to earn money.”
Camilo Avilez Aldea Gualcea, Mpio Gualcince
24
evaluator observed this to be the case); (iv) vegetables, potatoes are sold and provide
needed cash to cover loans and household needs. 
3.4 Who benefits?
EXTENSA works in 84 aldeas (villages) with groups of 28 farmers, seven of whom are 
‘model farmers’ (Productores Promotores) and 21 who are ‘student farmers.’ Model
farmers receive more intensive training provided by the project and are charged with
selecting and advising three student farmers. The PPs also serve on the directory of their 
aldea’s BRHIS. All 28 farmers carry out activities promoted by EXTENSA and also
constitute the total membership of the BRHIS. 
The PPs are seen to have benefited the most from the changes brought about by EXTENSA 
over the years. Although the PP’s work is voluntary, they have received significantly more 
training, and have more contact with project extensionists, and enjoy greater access to
materials (both donated and sold) provided by the project.10 In addition, because of their 
positions in BRHIS management, PPs are in a position to influence key group decisions.
The ‘student farmers’ consider that EXTENSA has benefited them as well, primarily
because of the chance to learn new agricultural techniques and acquire agricultural inputs 
on credit. Some also state that they enjoy being members of a group organization and 
believe that this has helped them improve their farming and helped them get ahead.
There is, however, a difference between the benefits for EXTENSA farmers who own land 
and those who must rent or sharecrop land. The former are able to adopt a full range of 
agricultural practices and inputs and thereby increase the value of their farm assets. The 
latter do not. Aside from planting a limited number of perennials and some vegetables 
around their homestead landless EXTENSA farmers, at most, are able to benefit from the 
boost in maize and sorghum production that results from high yield variety seeds and
chemical fertilizer. Access to these inputs by means of their BRHIS becomes the prime 
benefit for these farmers.
 
10 Project records indicate, for example, that while PPs represent 25 percent of total 
EXTENSA participants, they account for 52 percent of total drip irrigation system 
beneficiaries.
“Five years ago we did not produce enough. Corn only lasted us some two to three months. Crops of 
corncobs and beans were bad. The children were malnourished with their bellies distended and their hair 
falling out. Three of my siblings died. My father used to do journey-work in coffee farms. Now the corn 
lasts us all year and we have surplus to sell. We have vegetables and fruits and coffee. The beans don’t 
last us all year but we sell coffee and buy beans. We don’t go out to work anymore.”
Angela Manueles Aldea Semane, Mpio Yamaranguila
25
EXTENSA participants are overwhelmingly male. Only eight percent of EXTENSA
participants are women. Men who were interviewed state that when they are unable to 
attend BRHIS meetings their wives go, yet it is unclear to the evaluator to what extent 
wives share in key decisions, either in the banks or in the homesteads. Wives who were 
interviewed were generally positive about EXTENSA, but were unable to provide specifics 
and always referred the evaluator to their husbands for more information. Given 
EXTENSA’s lack of emphasis on gender considerations, combined with women’s evident 
subordination in rural Honduras, wives can only be seen as dependent beneficiaries (in the 
same manner as their children) of a general improvement in overall household consumption 
patterns. 
The evaluator was able to interview three women members of EXTENSA, two of whom 
clearly takes an active role in project-sponsored activities and have been rewarded with 
considerable success (see box). However, it would appear that this woman is the exception 
that proves the rule. 
EXTENSA involves only 28 farmers in aldeas that usually have considerably larger
populations, typically between 60 to 220 households. While new members are recruited 
when a farmer drops out of the group, the latter has not increased in size over the years in 
response to demand. EXTENSA members explain that other farmers aren’t interested in 
what EXTENSA promotes or that they do not want to risk taking out loans or perhaps that 
they are not altogether trustworthy. However, when pressed, most acknowledge that they 
can think of farmers who are interested and potentially good candidates for BRHIS
membership. When asked whether they think that the BHRIS could be expanded to 
include more people, most think that it would be possible except for the fact that current 
regulations stipulate that the banks should have 28 members. 
“The reason I am a member of EXTENSA is that I always like to be organized. I join groups and if I like them 
then I stay. I did like it (EXTENSA). Ever since it started, I’ve always liked it. They teach and one practices and 
one sees what is good. There is a lot of practice and there are many who are harvesting. There are some women who 
would like it as well, but there are some who don’t have the land or their husband works it.”
Fermina Garcia Aldea San Francisco, Mpio Candelaria
“In 2000 there was a women’s organization that included the wives of the 
partners in the BRHIS revolving fund bank. Their objective was to obtain 
new knowledge on animal raising, new recipes, education on hygiene. But it 
failed. Women can participate in the BRHIS because they are members of the 
family, they work in the orchard, they get ashes from the wood-burning stove 
for the vegetable garden.”
Menesio Manueles BRHIS Coordinator, Aldea Semane, Mpio
Yamaranguila
26
Some farmers report having sold some of 
their new products to their neighbors. 
However, it is unclear whether this is a 
wide-spread phenomenon. Overall, it 
cannot be said that the changes promoted 
by EXTENSA and benefits accrued to its 
members have had any significant spread or multiplier effects.
11 EXTENSA farmers think 
that some of their neighbors have adopted a few of the practices promoted by the program. 
The most commonly mentioned is contour planting. Others include such practices as not 
burning fields and the use of chemical fertilizers. The evaluator was unable to determine 
whether these were planted as live barriers. With the exception of two farmers who
reported that they have sold pineapple shoots and vetiver grass to their neighbors, no one 
interviewed described an example of a transaction in which an EXTENSA activity required 
participants to buy something from their neighbors or sell them products they required for 
their own economic activities.
 
11 Spread effects refer to non-members replicating practices they observe and which results 
in a horizontal spread of a particular activity, as, for example, the adoption of a particular 
crop or innovation. Multiplier effects refer to up-stream or down-stream benefits generated 
as part of a larger value chain resulting in a more complex and interdependent pattern of 
economic activity. 
“Yes, there are families who want to join but the funds 
are not sufficient. But as the funds increase, more 
could be allowed to participate. The CARE 
extensionists say no more than 28.”
Camilo Avilez Aldea Gualcea, Mpio Gualcince
27
3.5 Will the changes last?
In the eyes of farmers interviewed for the present evaluation, many of the changes set in 
motion by the EXTENSA project are here to stay. When asked about their future plans, 
farmers all describe steps that they will take to consolidate their gains and enhance their 
productive assets. Virtually all these plans point to the next logical steps down a path of 
further agricultural intensification and (for many) increased engagement with market
economies.
From an evaluator’s perspective, there are some elements of change that would seem to be 
more sustainable than others. Among the former are: 
(i) Highly diversified hillslope agroforestry systems. As described above, most 
EXTENSA farmers interviewed have adopted key practices that enable them to 
intensify their production, increase harvests, and lower their risks.
 
(ii) Farm assets such as soil conservation structures and high value perennials. 
EXTENSA farmers have made a commitment to agroecological sustainability 
by investing in structures and practices that enhance (rather than mine) their soil 
and biomass resources. They have invested in fruit trees and retain valuable 
wood species, both of which represent long-term investments.
Farmers talk about their plans for the future
“In future, I will grow strawberries with drip irrigation.”
Antonio Sanchez Gomez Aldea San Jose Mpio Guajiquiro
“One must get ahead in life. In two years I will have a peach crop. We will think of another project. CARE helps us form a 
trading committee for selling in the best market. There is also an irrigation group project.”
Luis Hernandez Gomez Aldea San Jose Mpio Guajiquiro
“I will grow more grass because it sells well.”
Evaristo Vazquez Aldea Sta Lucia, Mpio Sta Ana
“I will grow more in the ground-plot: cinnamon and cocoa in the shade.” 
Marcos Granados Hernandez Aldea Sta Lucia Mpio Sta Ana
“I will look after the variety of corn. The hybrid is good to trade with but the indigenous is the best.”
Pedro Vazquez Aldea Semane Mpio Yamaranquila
“I’m not going to plant corn anymore, just a little. I will cultivate mangoes, oranges, and tangerines. I have 80 mango trees, 40 
orange trees, and 30 tangerine trees.”
Ramiro Gomez Aldea San Jose, Caserio El Horno, Mpio San Marcos Sierra
“I will make more organic fertilizer. I will increase the grass barriers. I will increase my parcel for corn and beans.”
Alejandro Cantarero Aldea San Francisco, Mpio Candelaria
“I will work my parcel more. I will enlarge it and add to it a windbreak curtain.”
Felipe Leyva Aldea Gualcea, Mpio Gualcince
“I will plant more fruit trees: mango and orange trees. Traders already come here to buy corn and beans. In the future they may 
buy other products.”
Jose Felix Echeverria Aldea Gualcea, Mpio Gualcince
28
(iii) Small scale drip irrigation systems with market access. Approximately 400
EXTENSA participants now operate drip irrigation systems. Those who are 
located in reasonable proximity to market towns on all-weather roads have
excellent chances to make a transition to small scale cash crop farming.
(iv) Organic fertilizer practices linked to cash crop production and seedbeds. 
Enhanced soil fertility is necessary for systems that make a successful transition 
out of slash and burn agriculture to more intensive farming. Most farmers
interviewed understand that increasing organic composition of their soils is
crucial for plant growth and humidity retention and have adopted one or more 
organic fertilizer techniques.
 
(v) BRHIS that have been consolidated and are able to acquire their own materials 
and equipment (see section 6 below). 
Changes promoted by EXTENSA that may not endure in the longer term include: 
(i) Increases in maize production dependent on chemical fertilizers. In view of 
medium term trends in the price of oil, the price of chemical fertilizers will 
continue to rise. This may not be the case for maize, in particular, if trade
agreements increase US grain imports. EXTENSA maize farmers will then be 
caught in a scissors effect of rising input costs and depressed market prices. 
Beyond economics, chemical fertilizer use that is not accompanied by
investments in hillslope soil conservation will accelerate erosion, silting and 
flooding. EXTENSA tenant and sharecropper maize farmers who depend upon 
them will not be able to sustain their production gains over the long term. The 
use of hazardous herbicides such as Gramoxone and 2,4-D under poorly
controlled conditions, add another element of risk to the enterprise.
(ii) Micro irrigation of cash crops in aldeas located far from markets or on FFW 
feeder roads. EXTENSA works in many aldeas that are either too distant or 
very poorly communicated. Some aldeas are too isolated to make it 
economically feasible to engage in cash cropping on any significant scale. 
While FFW road construction and repair have alleviated the problem for some 
of these aldeas, allowing farmers to get their crops out or (more frequently) 
intermediaries in to buy them at farm gate. However, unless municipalities take 
over the responsibility for road maintenance, this will be a short-lived 
phenomenon. 
(iii) BRHIS that have not been consolidated and are dependent upon CARE to
acquire materials and inputs or whose focus is primarily upon chemical
fertilizers (See Section 6 below). 
(iv) Benefit streams limited to a small number of total aldea households (see Section 
6 below). 
29
(v) Benefit streams that emphasize women’s dependant status. Few women are 
active participants in EXTENSA. Many agricultural projects in Latin America 
and elsewhere successfully involve women in homestead gardening and
horticulture, thereby helping them to improve both their economic situation and 
social status. EXTENSA has not learned from those rich experiences and 
thereby not been able to leverage meaningful change for women. 
3.6 What processes will sustain changes and benefits?
The EXTENSA model is based on two key interrelated elements. The first is an
agricultural extension model based upon direct CARE staff involvement in training,
follow-up and guidance focused upon ‘model’ farmers and their three ‘students.’ The
second is a revolving credit mechanism that allows aldea-based groups to access
agricultural inputs on credit. In the opinion of most of those interviewed, both have played 
a role in bringing about and sustaining the changes and benefits they now experience. 
Extension Model. When asked what advice they would give CARE to improve EXTENSA, 
farmers invariably stated that CARE should continue to provide training and materials. 
Many of those who give this advice have been working with CARE for six to eight years. 
Aside from expressing a genuine feeling of appreciation for the organization, the outside 
evaluator also detected an undercurrent of uncertainty, even dependency, among those who 
responded to the question.12 Despite their tangible accomplishments, none of the farmers 
expressed a sense of completion or autonomy. 
As a group, the 28 EXTENSA farmers now possess a wealth of know-how and experience 
as well as farm assets that have, by their own report, improved their current production as 
well as expectations of future returns. Many have gained experience marketing their
products. Although most complain that prices paid for their crops have been low, none 
reported an outright failure. 
In summary, (despite its participants’ apprehensiveness) in the evaluator’s view, the
EXTENSA model has contributed towards significant change and sustainable benefits for 
the majority of the farmers involved. However, as described above, these changes have 
affected a somewhat narrow slice of total farmer population. The EXTENSA model is 
predicated on model farmers and small participant groups. Changes appear not to have 
diffused beyond a somewhat ‘encapsulated’ beneficiary group, thereby limiting project
impact and, in some cases, creating resentment among other community members. 
Moreover, as described above, the guy-to-guy ‘model’ farmer approach has bypassed
women and thus been unable to harness the energies, talents and imagination of the entire 
household. 
 
12 It should be noted that the question posed was not whether or not EXTENSA should 
continue to work with the group, but rather advice as to how to improve project 
performance. However, all responses gravitated to the issue of continuity.
30
Revolving Credit Mechanism. Community-based revolving credit systems promoted by
agricultural development projects experience high failure rates after the sponsor leaves. The 
factors and circumstances resulting in revolving bank failure are endemic to the risks
experienced by small-scale farmers enmeshed in market systems over which they have no 
control, and to the myriad economic and social pressures affecting fragile community
solidarity groups. 
In this regard, the BRHIS groups visited in six EXTENSA aldeas present a mixed picture. 
Two out of the six groups appear consolidated (as measured by reported high loan
repayment rates,13 low membership turn-over, construction of storage and meeting 
facilities). Moreover, these groups report that they now administer the entire cycle of input 
purchases and distribution. In both cases, the aldeas are located on reasonably good roads 
close to market towns. All those interviewed in these towns now produce vegetables and 
other products for sale in these markets.
The other four BRHIS groups exhibit varying degrees of weakness. Perhaps the most
significant is a dependence upon CARE project staff to purchase inputs. In these cases 
CARE acts a wholesale buyer of materials and equipment that group members order. In 
one case, CARE purchases materials and transports them to a warehouse in the municipal 
center, from where they are picked up by BRHIS representatives and taken to their aldea. 
In another case, the CARE extensionist transports inputs to the aldea in a project vehicle. 
This is clearly unsustainable. Other BRHIS groups serve mainly as a conduit for chemical 
fertilizers. If these become too expensive, then the BRHIS may no longer serve a purpose 
and their membership will probably disband.
3.7 Conclusions and Recommendations.
Conclusion 1. By an overwhelming majority, farmers report and describe changes in their 
agricultural practices, farm assets, production levels and (current or expected) cash income 
that have resulted from their participation in EXTENSA. It can be concluded that the
technical and loan package promoted by the project is appropriate in that it responds to 
farmer’s needs and their circumstances. 
 
13 It should be noted that the evaluator did not examine BRHIS inventory or loan records 
since this would have sent mixed messages to project participants. She did have 
opportunity to view facilities in all six sites. 
“We used to say that we are poor, and we were just sitting there saying that we are poor and that 
the land is poor. Now we know that the land isn’t that poor but that you have to know how to 
work it.”
Ramiro Gomez Aldea San Jose, Caserio el Horno, Mpio San Marcos de la Sierra
31
Recommendation 1. The basic EXTENSA technical and loan model should be retained in 
the upcoming DAP. The menu of specific agricultural practices and crop varieties should 
remain flexible in order to adapt to the different agroecological conditions that exist in its 
large and diverse project area. Project management should consider a small livestock
component featuring chickens and pigs. The solar stove and pump pilot should be
evaluated to determine whether costs outweigh benefits. 
Conclusion 2. EXTENSA’s strategy to address both short-term household needs, such as 
basic grains, and long-term investments in farm assets, such as agroforestry systems with 
high value perennials, has been a success. The revolving credit mechanism designed to 
underwrite this dual-track approach to agricultural intensification, has met with widespread 
farmer acceptance. Farm assets have increased significantly and risk has been reduced by 
means of diversification, soil conservation and micro-irrigation. The end result, as reported 
by farmers, has been in significant improvements in household grain self-sufficiency, lower 
rates of out-migration, greater availability of vegetables and (some) fruits for household 
consumption, more case income, and the expectation of future income streams when fruit 
trees mature. 
Recommendation 2. As with recommendation #1, EXTENSA should retain and build upon 
its current model. Small-scale drip irrigation systems should continue to be promoted 
where feasible. However, EXTENSA should continue to emphasize agroforestry and soil 
conservation solutions for rainfed fields since these (i) have been demonstrably successful 
in the current DAP and (ii) remain the principal resource base of the majority of farmers in 
the project area.
Conclusion 3. Male farmers have been the principal beneficiaries of EXTENSA training, 
extension advice, organization and material resources. Among this group, model farmers, 
who represent approximately 25 percent of project participants, have benefited from the 
largest share of the training, over half of the material resources and a key role in group 
decision making. Women represent a very small percentage of total project participants and 
farmer’s wives do not appear to take an active role in project activities, including training. 
Households do, however, benefit from increased and more diverse food availability, a key 
consideration in a food insecure region. EXTENSA appears to have generated few spread 
or multiplier effects in the larger community, thus it cannot be said to have clearly
benefited more than its own membership.
“The best of EXTENSA is the knowledge I acquired because I believe I am better off than I was before.They 
have broadened my mind so I can think about the best for the future. Today I have many dreams for further on 
and may God allow me to fulfill them.” 
Ramiro Gomez Aldea San Jose, Caserio el Horno, Mpio San Marcos de la Sierra
32
Recommendation 3. One of CARE’s top priorities for 
the upcoming DAP should be to design clear and
effective measures to increase community access to
EXTENSA’s benefits, either through expanded 
membership or explicitly designed measures to
enhance spread or multiplier effects. EXTENSA should 
also reduce the benefit gap between model farmers and 
other farmers. Most importantly, EXTENSA needs to 
design effective pathways for significant numbers of women to become actively involved in 
project activities and thereby enjoy a share of its benefits. 
Conclusion 4. Most EXTENSA participants who were interviewed have achieved changes 
in their farming practices, productive assets, and organizational capabilities that promise to 
increase their productive capacities and standards of living over time. The prospects for 
some farmers and groups are somewhat more fragile. These include: those who depend 
exclusively upon chemical fertilizers to increase yields; cash cropping in aldeas located far 
from markets or on FFW feeder roads; and BRHIS groups who depend on CARE to 
purchase and/or transport materials.
Recommendation 4. During the final year of the current DAP, EXTENSA should take steps 
to assist dependent BRHIS groups to purchase their own inputs. CARE should also conduct 
a study of options for farmers who depend exclusively on chemical fertilizer and herbicides 
to increase yields. Integrated pest management techniques for grain and vegetable and fruit 
crops should be an integral part of EXTENSA’s technical extension package. Marketing 
needs to be a central theme in the final year of the present DAP. These more viable 
alternatives should be incorporated in the upcoming DAP. EXTENSA should also
coordinate with PODER to ensure that municipal governments commit to the future
maintenance of FFW roads. 
Conclusion 5. The EXTENSA extension and 
revolving credit model based upon model
farmers and small participant groups has
achieved significant change for a limited
number of farmers. EXTENSA staff has been 
directly involved in service delivery for these 
groups, who, in many cases, have become
dependent upon them. CARE extensionists
“I have nice plans for the future. I want to fill the maize-field with trees and buy the 
neighboring land for a maize-field. With what I sell, I can send my son to La Esperanza for 
secondary education. I have four daughters. We all work. They should study so they don’t just 
have to depend on their husbands.”
Angela Manueles Aldea Semane, Mpio Yamaranguila
“There is only one woman who is a 
member of the group. Perhaps we have 
failed.”
Jose Felix Echeverria 
Aldea Gualcea, Mpio Gualcince
“We want another five-year plan. We want 
more CARE extensionist visits. We always 
desire technical assistance from CARE and the 
help of the loans.”
BRHIS group members. 
Aldea San Francisco, Mpio Candelaria
33
have not conveyed the concept that EXTENSA, like any project, has a clear beginning, 
middle and end.
Recommendation 5. EXTENSA needs to use the final year of the current DAP to focus on 
steps that help BRHIS groups make a successful transition to independent operations. This 
will require planning with groups slated for a final year. It will also require CARE staff to 
deploy different attitudes and skills given that CARE extensionists need to step back from 
tasks that participants will need to accomplish by themselves and become more facilitators 
than doers. CARE should also build into the following DAP a straightforward three phase 
project cycle design and make it the centerpiece of its on the ground operations. 
4. PODER FINDINGS AND RECOMMENDATIONS.
4.1 Introduction.
The aim of the methodology for the PODER project evaluation was to use techniques and 
events that would allow the evaluator to approach key actors in order to identify the
changes resulting from the project as well as identify its limitations and weaknesses, and 
generate recommendations to improve future actions. 
To this end, the evaluator chose two techniques: semi open ended interviews using a
question guide that allowed for follow through questions derived from responses. There 
were three kinds of interviews depending on the person being interviewed: (i) leaders of 
community organizations (CODECOS, patronatos, water user groups, etc.);14 (ii) leaders of 
the Comision de Proyectos and participants and HOGASA and EXTENSA
representatives;15 (iii) mayors, members of municipal councils and municipal
functionaries.16 Almost all interviews were tape recorded.17
The second technique used was that of evaluative workshops, carried out with community 
leaders and municipal officials, to identify and assess the changes brought about by
PODER.18
 
14 Leaders of CODECOS, of the patronatos of Guajiquiro, and others groups in 
Yamaranguila were interviewed.
15 It should be noted that HOGASA and EXTENSA representatives always were present 
during the interviews with community leaders in Guajiquiro and Yamaranguila.
16 Mayors of Guajiquiro, Yamaranguila and Gualcinse were interviewed. The mayor of 
Santa Ana participated in the workshop carried out in her municipality and the vice mayor 
of Candelaria participated in the one carried in that municipality.
17 The evaluator also interviewed two CARE field staff: the PODER field coordinator and 
one field extensionist. 
18 See Annexes__ and ___ for summaries of the workshop results and analytic matrices, 
respectively.
34
In addition, the evaluator visited roads projects, housing, municipal infrastructure and
community organization headquarters that have received PODER project support.
4.2 Have things changed?
Honduras has a long tradition of food assistance linked to works projects that improve 
community well being. It is undeniable that, in one way or another, these have had positive 
results insofar as they have helped impoverished families and communities to resolve their 
food availability problems. However, some critics of FFW point to the distorting effects 
food rations have on community initiative.
CARE’s FFW strategy focuses on promoting and strengthening the underlying elements of 
a community development process: knowledge, organizational structures, attitudes and new 
practices, interactions between citizens and officials, and synergies among community
organizations, health, production and roads.
The changes promoted by PODER are many and these have been generated at different 
levels and with diverse actors.
Changes in community organizations. In five of the six municipalities, leaders have
remarked on the coordination roles of patronatos and CODECOS, not only to organize 
group activites related to CARE’s FSP but also to organize overall activities that are carried 
out in a community.
Members of community organizations believe that these have grown internally in terms of 
how they function and their capabilities to plan and implement projects.
Community leaders talk about coordination
“There is good communication with the groups.” Candelaria
“They relate through leaders and equitable projects through the integration of municipal organizations.” San Marcos de la Sierra
“The relationship between CODECOs and other groups is that we involve all the live forces in the community and other organized 
groups within and outside the municipality for an exchange of experiences.” Santa Ana
35
Community organizations tend to view their relations with their municipality in a positive 
light and report these as greatly improved given that they see the latter as more responsive 
and more open to dialogue. 
Participants in the evaluation workshops reached a number of conclusions about the
difficulties of the community organization process and identified weaknesses that need to 
be addressed. 
CODECO, patronato, comision de proyecto and HOGASA and EXTENSA representatives 
identified the following difficulties:
l irregular and low participation by members
l scarce new leadership and few women in leadership roles
l low levels of schooling
l insufficient educational materials for HOGASA
Community organization representatives identified the following areas to improve:
l organizational structure
l participation and forming new leaders
l basic sanitation and selection of CHV (HOGASA)
l expanding BRHIS membership and taking women more into account in agriculture
Community leaders talk about improved organizational capacities
“Training on human resources and good management, recognition of the investment made by the organization, the people are 
organized… planning of time, administration of money and materials, availability of time.” Candelaria
“Change in personal and community life, through gender and by means of education and training in different areas… it is projected 
through its direct participation in the direct construction of prioritized projects. Prioritization of community needs and preparation of 
community plans, as well as requisition of budgeted products, has been learned.” San Marcos de la Sierra
“The CODECO organization functions 80 per cent better than five years ago, with the trainings and technical and financial support. 
We involve men, women, youths, projects committees, and CODECO. To carry out the planned project we perform the execution 
through the municipal corporation and PODER.” Santa Ana
Community leaders talk about their relations with municipal officials
“There is communication, the groups get together and follow through, there is good administration.” Candelaria
“It has improved through communication in open town meetings, municipal forums, and in joint works.” San Marcos de la Sierra
“Five years ago there wasn’t a constant relationship with the municipal corporation and CODECO; mow there is a better relationship 
between CODECOs, municipal corporation and PODER as to the projects presented to the institutions within the municipality. We 
relate even more with thte municipal corporation based on the internal policy and guidelines obtained from CARE-PODER.” Santa 
Ana
“Average… the corporation considers us very little.” Gualcince
36
Community leaders demonstrate insights into the dynamics of their organizations. Some of 
the difficulties, such as participation and responsibility issues, should have been overcome 
in mature organizations. Nevertheless, others, such as the search for new leadership talent 
and the recognition that leaders need to multiply knowledge and skills is a signal of strong 
organizational development. Suggestions of areas of community organization that need to 
be improved are all valid, in particular, those related to EXTENSA coverage and
monitoring of household sanitation.
Changes at the municipal level. There are also changes that have been generated at the 
level of municipal officials and municipal structures.19 (see box below)
The evaluator considers that the answers and testimony of the mayors and regidores are 
eloquent about the changes that have taken place. Moreover, it is possible to identify 
improvements in municipal management and administrative capacities according to the
following measures:
(i) An increase in social and human capital in organizations and communities that 
has helped increase their self esteem and capacity to express their demands;
(ii) Methodological and operational assistance to develop municipal long term
strategic plans (2004-2015);20
(iii) Provision of equipment and training to municipal staff for better data
management;
(iv) Strengthening of a capacity to dialogue, negotiate and reach agreements
between municipalities and patronatos and CODECOS;
(v) Increased internal capacity of municipal corporations in management due to
delegation of authority and the competencies of regidores;
21
(vi) Strengthened capacity to coordinate and establish inter-institutional links at the 
inter-municipal, departmental, regional, national, and in some cases,
international, levels.
 
19 Underline emphasis in box by the evaluator.
20 Guajiquiro, Santa Ana, San Marcos de la Sierra and Candelaria expressed wholehearted 
satisfaction with the participatory planning process facilitated by PODER.
21 Except for Santa Ana where the mayor, due to internal disagreements, has a weak 
relationship with the regidores, and the mayor of Gualcinse who stated that he has been 
unable to delegate functions to the regidores, the rest of the municipalities visited show an 
optimal integration between regidores and mayors.
37
Municipal government representatives in the evaluation workshop identified the following 
difficulties in the municipal strengthening process:
l political party influences
l scarce economic resources
l isolation of some areas within the municipalities
l non-functioning municipal development councils (in 3 out of 6 municipalities)
Municipal government representatives identified the following areas that can be improved:
l bring technical skills up to date
l gender equity
l relations among regidores
l closer citizen relations
l delegating functions to community leaders in isolated areas
l follow up on staff training
l delivery of food rations in aldeas and caserios
l monitoring of work
l expand coverage in communities (EXTENSA)
It should be noted that municipal government representatives have identified complex
problems such as political sectarianism, which require long term solutions and can only 
change insofar as Honduras’ political culture changes. Likewise, the lack of economic
resources is contingent on central government policies that support local development.
Other issues, such as improving the municipal development councils, can be handled at the 
local level. It is encouraging to see that some municipal representatives mention gender 
equity. Likewise, concern over citizen participation, delegation of authority and monitoring 
of activities, shows a commitment to community empowerment.
38
Changes at the household level. Based on opinions expressed during interviews made 
with members of HOGASA and EXTENSA on the Comision de Proyectos, the evaluator 
recorded a number of changes at the household level (see box below).
The key changes at the household level relate to: (i) membership in FFW teams to carry out 
communal activities that result in direct benefits to families or communities; housing, roads 
and increased knowledge about nutrition, health and agriculture. Learning about aspects 
related to opening and maintaining roads; (ii) the opportunity to become involved in
organizational processes afforded by PODER, EXTENSA and HOGASA.
Municipal officials talk about change
“I think that the previous corporations did not have their work areas defined. Thus, if they manager a small program empirically, it had no technique, 
nothing prepared with correct logical order. And we are developing through an organization, supported by CARE… It is the systemizing of data in our 
municipal offices pertaining to Secretaryship and Land Tax Office… We have a computer system with capable people… In the Land Tax Office, that it 
weren’t a person purely empirical in accounting, more than anything, and that is progress for the municipality, because, leaving aside that our financial 
part is small, control is needed.” Council Member of Guajiquiro
“Now the Municipal Corporation designates responsibilities. There is a council member in charge of health, in charge of education, infrastructure and so 
on, and then facilitates that. Truly we are working based on a municipal plan; we know where we’re at and how far we’re going to go.” Municipal 
Council Member of Guajiquiro
“We continually visit the communities of the municipality, 42 villages. We are emphasizing that, logically our people need support, and this support in 
food comes to reinforce, rather, the desire to work. This results in stimulating these people to form part of the projects. However, at the Corporation we are 
emphasizing that our people not only grow accustomed to that but that they are scrupulous that these projects are properly of the community and and that 
they are the ones who must carry out those projects with no payment required. In this aspect we at the Corporation are doing all that is possible so that our 
people take the projects for their own.” Municipal Mayor of Guajiquiro
“When CARE came to the municipality there were no development processes or community participation. At present the change at community level has ben 
observed. Support in municipal strengthening, training the employees in different areas, office equipping, how to follow through projects with different 
institutions, sharing experiences with institutions of other countries (Caritas Nicaragua), coordination with the institutions, long-term strategic plan, 
trainings, exchange of experiences with the northeastern micro-region of Morazan, El Salvador.” Mayoress of Santa Ana
“Training was given to respond to the realities that are lived. Planning is created to solve needs that are felt. Values and self-esteem are recovered. The 
citizens tend to express their ideas.” Vice-Mayor of Candelaria, Municipal Secretary and leader teacher
“Change of attitudes in the family and communities, improvement of the living conditions, analysis of experiences. Many things have been achieved that 
were ignored.the education and the capability to solve problems have been improved.” Municipal Secretary of Gualcince
“We have acquired knowledge on infrastructure, EXTENSA and HOGASA, trainings received for better administration.” Vice-Mayor and Council 
Members of San Marcos de la Sierra
“Support the aspect of instituitional coordination. We haven’t gone to exhaust resources. Efforts have not been duplicated with who is working. There is 
no competitiveness either.” Mayor of Yamaranguila
39
4.3 How significant have these changes been?
According to PODER’s operational manual, the projects overall objective is to “improve in 
a sustainable manner institutional capacity at departmental, municipal and community
levels to plan, manage and implement development activities to improve household
livelihood security, with emphasis on food security, of the most vulnerable populations.” 
The results of the evaluation workshops in the three municipalities show that this overall 
objective has been met. 
(i) As a rule, patronatos, as such, have not enjoyed any support or strengthening in 
Honduras. PODER developed a process of organizational capacity building,
planning and management that has increased the functional capacities of
community organizations, and, moreover, has restored a coordinating role to
diverse community groups.
(ii) With support for establishment of the CODECOS, in many communities there 
are now greater and better levels of coordination among all community groups, 
without overshadowing any existing entities, given that all are involved in
projects. There remains the matter of the relationship between the CODECOS 
and patronatos, wherein there are still some tensions, especially on the part of 
the patronato leadership.
(iii) A significant point is that both entities play roles in community management 
based on technical operational criteria, rather than political lines characteristic 
of patronatos in the past. The vehicle for joint activities has been the
Community Action Plans (CAP).
Members of the FFW Proyects Committee speak
“Participation of each one of the families. Monthly meetings are held to make clarifications to all the participants on the work 
methodology. The opening and maintenance of roads is development for the communities. The people who work should be 15 
years of age and older, two persons per family are accepted at the work… How to maintain the streets, how to make sewage 
systems.” Santa Ana Projects Committee
“We have had formation of leaders and drawing near between families and persons from other municipalities, carrying out road 
opening and sewage system works for the improvement of dwellings, lessons on management of resources, on infrastructure, on 
supplies.” Projects Committee of Candelaria and Gualcinse
“In the neighborhood of Los Mangos there are eight dwellings that were built. It is a joy for us. I have three children and am a 
woman who has no husband, but I am happy with my children living in my house.” 
Leader of the Los Mangos project committee in Semane
“Preparing community plans, carry out drainage works, learn to work organized.” San Marcos de la Sierra
“We have been trained in integral care of children in the community and on the integrated offering of health services.” Members 
of HOGASA in Santa Ana
“We have been trained in seed diversification, soil conservation, handling of stubble, horticulture, pesticides, Market and 
production registration.” Members of an EXTENSA BRHIS
40
(iv) Municipal authorities have played an important role in articulating community 
groups. Honduras history of citizen participation is relatively new, beginning in 
the 1990’s. Until recently, it was not usual for community groups to identify 
projects and, much less, come to agreements with municipal authorities. Now it 
is a common occurrence and established within CODECOS and patronatos, 
resulting in a culture of citizen participation.
Municipalities that are encompassed in PODER’s project area are those classified in
category C and D according to the Ministry of Interior. These municipalities are
characterized by having simple administrations that requires considerable institutional
strengthening. Therefore, support and strengthening of these governments represents a
significant advance. The principal changes that have been achieved are:
(i) Support for municipal governments in formulating a strategic vision of
municipal development by means of 2004-2015 municipal strategic plans.
(ii) Reactivation of mechanisms for citizen participation such as municipal
development councils, (which function well in some municipalities such as
Yamaranguila, Candelaria, Guajiquiro) open town meetings, and plebiscites.22
 
These mechanisms have been widely adopted by municipal authorities and are 
accepted by the population.
(iii) The use of community action plans as a means for budget implementation is 
becoming more frequent in municipalities. This helps municipalities to orient 
their interventions according to community priorities.
(iv) Donated equipment to municipal offices has helped improve administrative
processes and management. Municipal staff has improved its capacities, a
development that should be monitored over time.
4.4 Who benefits?
The changes promoted by PODER have been focused primarily on the members and
leaders of the CODECOS and patronatos, along with the mayors, regidores and municipal 
functionaries. 
Moreover, communities have benefited, directly or indirectly, from the changes given that 
organizational strengthening and municipal management has been reoriented to benefit
communities and their constituent households.
 
22 According to the mayor of Yamaranguila, PODER provided important assistance to carry 
out a plebiscite over prohibiting alcoholic beverages. Preparations took six months at the 
end of which citizens voted on the issue. 
41
Families have also benefited, insofar as some of their members form part of community 
organizations (women’s groups, parent associations, water user committees) that have
participated in trainings and have increased their knowledge about aspects of community 
life: project design; planning; management and relations with municipal officials. 
Families have also benefited directly from FFW activities, such as roads, either by working 
on them or by enjoying better communication, by housing improvements. 23
 
4.5 Will the changes last?
Whether or not the changes documented in this investigation last, depends in great measure 
on the learning that participants have acquired by participating in PODER or in the other 
two projects of CARE’s FSP. PODER and the other two projects have created a knowledge 
base linked to functional structures of thematic groups, such as the comision de proyectos, 
the CHV network, the BRHIS members, that are articulated by the CODECOS and
patronatos (where there are no CODECOS). It is clear that the knowledge and skills 
acquired are now applied in household and groups settings,. However, these depend on the 
existence of projects, such as CARE’s, that have material, human and institutional
resources, a shared operational base and are able to generate synergies. This implies a 
serious difficulty in terms of sustainability because, although there are elements to establish 
municipal food security programs, these are still unlinked pieces. It is uncertain whether 
municipal food security programs can be based on local initiative since, although there is 
talk of an exit strategy, CARE is the only one that promotes and knows about it. 
 
23 In Santa Ana, the housing program carried out in the township and in nearby 
neighborhoods, has mainly benefited single mothers.
Participants talk about what has been learned
“We have acquired knowledge on infrastructure, EXTENSA and HOGASA, trainings received for improved administration.” Municipal 
government in San Marcos
“Education and the capability to solve problems have been improved.” Municipal government in Gualcinse
“Better execution and vision.” CODECOS in Candelaria
“How to make organization processes, preparation of the PAC.” CODECOS in San Marcos de la Sierra and Yamaranguila
“Management of resources, about infrastructure, about supplies, about coordination and planning.” Project Committees in Candelaria and 
Gualcince
“Carry out drainage works, learn to work organized.” Project Committee in San Marcos
“The preparation of the PAC and the work plans of our communities. How to maintain the streets, how to make drainage ditch systems, how to make 
sewage systems, fords, and bridge boxes.” Project Committee in Santa Ana
“We have been trained on management of internal policy, registry of funds, reforestation of microwatersheds and preparation of the microwatershed 
management plan.” Members of water user committee in Santa Ana
42
This is a key point in terms of whether or not changes can be sustained through time. 
Workshop participants and others interviewed had decidedly mixed opinions (see box
below). In their responses, many people believe they have capacities, skills and motivation 
needed to take on the required tasks, yet reveal that there is still an enormous need for 
continued external support, from CARE, not just PODER.
4.6 Conclusions and Recommendations.
Conclusion 1. The processes advanced by PODER have brought about important changes 
in community organizations, municipal authorities and households. CODECOs and
patronatos coordinate better with other groups. In general, organizations have improved 
their planning and project implementation capacities and communicate more effectively
with municipal governments. The latter now dialogue with community organizations and 
take into account the community priorities in Community Action Plans.
Recommendation 1. CARE should continue its support for CODECOS and patronatos, 
focusing on standardizing their regulations consistent with municipal norms. It is also
important to advise municipal governments on mechanisms that will ensure that
Community Action Plans are included within Municipal Strategic Plans. 
Participants talk about whether they can carry on alone
“Some projects can be carried out alone, others can’t.” CODECOS from Candelaria and Gualcince
“We cannot advance in the development of the municipality and of the community; we always need the support of institutions and 
of the municipality because of the scarce economic resources because the entire population is not prepared education-wise.” 
CODECOS and patronatos from San Marcos de la Sierra
“Through training, they have told us about the sustainability of projects, but we need institucional support to cover 100% the 
planned long-term projects and to fulfill the goals; we as CODECO need to learn to follow through and learn how to train others.” 
CODECOS from Santa Ana
“Yes we can but we need more support from the technicians.” EXTENSA representatives
“We cannot yet becayse we are lacking knowledge and economic resources and we will need the SSP.” 
HOGASA representatives from Candelaria and Gualcince
“Yes, we can continue alone in some aspects; for example, in sustainability of the organization, sustainability of the funding 
obtained, raw materials, human resources and responsibility. We cannot continue alone if we do not receive more training.” 
HOGASA and EXTENSA representatives from Santa Ana
“At present the capability does not exist, but we count with some trained personnel (the Corporation) and some other professionals. 
We do not sufficient economic resources.” Candelaria Municipality
“Speaking of sustainability since perhaps in the organizational aspect it would not be the difficulty as much as, if we look at the 
rest, the support we receive, we won’t have food anymore, if we value that it is millions. In this we cannot say that for us it is 
easier. We will have problems because we will not have all those aids.” Mayor of Guajiquiro
“There is no capability for sustainability, follow-up, monitoring, and execution of projects.” 
Gualcince Municipality
43
Conclusion 2. The changes achieved in the CODECOS and patronatos are important for 
community and municipal development because both structures are oriented to play a role 
in community management based on operational technical criteria, as distinct from the
more political issue orientation characteristic of the past. In the case of municipal
governments, these are characterized by rudimentary administration that required much
strengthening. Thus when afforded this support, they have improved their management 
capabilities (vision, strategies, the use of legal mechanisms to promote citizen participation, 
office equipment) and are now in a position to carry out genuine municipal development.
Recommendation 2. Strengthen the technical capacity of community organizations to
undertake social management by developing a technical guide summarizing the
methodologies and procedures that CARE has formulated over the course of the project. 
Continue to support municipal management, in particular, instruments for agreements,
planning and municipal administration.
Conclusion 3. The main beneficiaries of these changes have been community
organizations, (the general membership and the directories) municipal governments,
(authorities and functionaries) and households, given that household members (both men 
and women) form part of community organizations (such as women’s groups, parent
associations, water user committees) that have participated in trainings that have increased 
their knowledge about these aspects of community life.
Recommendation 3. It would be worthwhile to inform the wider population of the
important actions undertaken by their community organizations and municipal
governments on behalf of families and communities.
Conclusion 4. Currently, there are community leaders and municipal staff who possess the 
knowledge and institutional expertise to develop a municipal food security plan. Despite 
this, the program’s municipal exit strategy does not include such a plan. Therefore, it is 
difficult to guarantee the actions promoted by CARE at an integrated level.
Recommendation 4. Carry out sessions at the municipal level focusing on a transition plan
to prepare for CARE’s withdrawal. The plan should address elements of an integrated food 
security program encompassing HOGASA, EXTENSA and PODER. The plan should
identify real local capacities, as well as areas that remain to be strengthened, as well as the 
minimum conditions necessary for municipalities to continue to operate alone.
Conclusion 5. The main processes that help provide sustainability to the changes include: 
training in organizational strengthening; technical advice and support to improve municipal 
management; and inter-municipal support and shared experiences within the framework of 
mancomunidades. 
44
Recommendation 5. CARE’s organizational strengthening should have a better focus. This 
requires differentiating among levels of organizational needs exhibited by different groups 
and municipalities. These will require different types of support in order to foster the kinds 
and pace of change most suited to their situation. In this regard is the support that can be 
afforded to mancomunidades, since these are key
5. NOTES ON PROGRAM INTEGRATION.
Aside from evaluating of the FSP’s three principal projects, the evaluation team also
addressed a number of crosscutting themes relevant to a transition period of an evolving 
integrated program. These themes include: (i) overlaps among projects that might generate 
potential program synergies; (ii) strategies that determine sustainable changes; and (iii)
CARE’s policy priorities to be taken into account in the upcoming DAP.
5.1 Project overlaps. 
EXTENSA production and the diets of HOGASA households. Despite the fact that some 
families participate in both projects, these appear to be in the minority and there is no 
significant overlap between the two populations. Interviews with HOGASA parents do not 
reveal much of an impact on their diets, since almost none had participated in EXTENSA 
trainings. In two of HOGASA group interviews, criticisms were made about the limited 
number of participants allowed in EXTENSA groups. Parents said that they would like to 
see EXTENSA expand to include more members. 
The few HOGASA beneficiaries who had participated in EXTENSA said that increased 
production had enabled them to diversify their diet with foods such as pineapple, yucca, 
and bananas. In other cases, HOGASA parents state that they have purchased foodstuffs 
such as fish, bananas and tomatoes from EXTENSA farmers.
PODER organizational and planning assistance to EXTENSA and HOGASA groups.
PODER expertise in organizational strengthening might be relevant to groups in the other 
two projects. This role is still in the future; currently it does not happen systematically.
FFW roads and EXTENSA and HOGASA. This has turned out to be an area of important 
synergies. The roads promoted by PODER have resulted in significant benefits for
EXTENSA farmers, several of whom reported that they or members of their families had 
worked on the roads. However, more important than this, the majority of EXTENSA 
farmers stated that the FFW roads have played a key role because roads now permit them to 
sell their products, either by transporting their crops directly to markets or because
intermediaries now are able to travel to their communities to buy them. 
Those interviewed for HOGASA, report that the new roads now allow patients to be 
transported to health centers in a timely manner thereby reducing mortality. Roads also 
45
allow government health staff to reach communities to provide assistance and carry out 
vaccination campaigns. 
FFW food rations in household economies. A number of those interviewed report that 
they receive rations both from HOGASA and for work on roads. These foodstuffs
contribute significantly to the household’s economy given that families do not have to
spend money on basic foods and are able to allocate their scarce cash resources on other 
priorities (such as food products that provide a more varied diet or fertilizer).
5.2 Determinants of sustainable change.
Volunteer-based community health services. The community health system based on
volunteers would appear to be sustainable to the extent that these continue to receive
additional support in the form of training, supervision of their activities and contributions 
of materials. Health volunteers are extremely motivated by their work and to continue to 
serve their communities. Support from Ministry of Health and from municipalities is
critical to sustain their efforts.
Beyond this, there are important unexploited opportunities for coordination between
HOGASA and EXTENSA given that many CHVs are also members of EXTENSA. Health 
volunteers could play a key role in future joint HOGASA and EXTENSA programming, as 
for example trainers for homestead gardens, grafting, integrated pest and pesticide
management, etc. for which they might receive remuneration either in cash or kind.
Producer Promoters’ multiplier capacity. PPs have played an important role promoting 
agricultural practices to EXTENSA members and also as members of the BRHIS
directorates. However, their impact outside this circle appears to be quite limited. However, 
their potential (as that of their EXTENSA member ‘students’) to influence greater numbers 
of farmers is very great. One of the measures that EXTENSA can take is to ‘graduate’ 
EXTENSA’s student farmers (especially women) who demonstrate that they can master the 
main agricultural practices promoted by the project so that they can, in turn, become
teachers and thereby expand services to more community members.
An integrated organizational strategy. Currently, CARE acts as an articulator among
projects, activities and organizations at the municipal level. If CARE withdraws it will 
leave a vacuum. The program lacks an integrative strategy that will enhance and sustain 
food security activities among the three projects after the organization leaves. CARE 
should make this a priority during the final year of the current DAP and focus upon helping 
municipalities involve CODECOS and patronatos in the design of municipal food security 
programs.
5.3 CARE’s policy priorities.
Gender. In HOGASA health volunteers are approximately 60 percent male and 40 percent 
female. This distribution reflects an excellent gender balance as well as a commitment by 
46
men to improve health in their communities. Furthermore, some fathers have attended
HOGASA educational activities and take a role in childcare in their homes.
Women’s participation in EXTENSA is quite limited, especially at the PP level.
Nevertheless, there are a small number of women who participate actively in the project 
and who have benefited significantly from the changes promoted by the project. In the case 
of one aldea, at least, a BRHIS is expanding its membership to include wives.
There is a strong potential to integrate HOGASA and EXTENSA activities focused on 
homestead gardens, including vegetable gardens, improved fruit trees and small livestock. 
This would generate opportunities to increase and diversify household diets for HOGASA 
and more active involvement of women in EXTENSA.
PODER has stimulated participation by women in CODECOS, patronatos and other 
community-based organizations. However, women usually do not occupy leadership
positions, such as presidents of directorates. One exception is in Sta Ana where three 
women are presidents of CODECOS; yet this is probably the result of the fact that Sta
Ana’s mayor is a woman.
It should be noted that out of PODER’s 27 extensionists there is only one woman. If 
CARE wants to promote more participation and gender equity in the organizations it
supports, then it would be important to promote the same among its own team, and thereby 
project a more consistent image. 
Empowerment and rights-based programming. During interviews, some HOGASA
parents mentioned the issue of their rights to health care in relation to government health 
services. This is a theme that has considerable potential to become part of trainings given to 
parents and health volunteers during the final year of the current DAP. If this theme is 
successful during this period, then it can be introduced as a regular part of the HOGASA 
training curriculum for the upcoming DAP.
In EXTENSA, the central rights based issue is access to the services provided by the 
project itself. It is important, therefore, to emphasize the rights of women to participate 
actively in project-sponsored trainings, to be members of BRHIS directives, and to close 
the gap between benefits received by the PPs and other EXTENSA members. It is also 
important for the project to identify sustainable strategies to favor farmers who have little 
or no land. Moreover, it is important (at the same time maintaining standards of technical 
excellence) to find ways to expand EXTENSA group membership and/or find multiplier 
and replication strategies that will benefit households who cannot become group members.
In general, community groups have increased their capacity to formulate and present their 
demands to municipal governments. They are also more able to oversee the activities of 
municipal authorities. 
CARE’s facilitator rol. Currently, there is a tendency in all three projects for CARE to 
take center stage and own the process. In the case of HOGASA, CARE’s active role in 
education and trainings could be reduced by giving health volunteers more training and 
47
responsibility and by expanding their coordinating role with EXTENSA. Options for pay 
for services should be explored in order to remunerate this increased responsibility. The 
EXTENSA project should also explore ways of delegating more extensionist
responsibilities to PPs and veteran farmers, and devise pay for services options through the 
BRHIS. 
In both cases (CHVs and PPs) it would be advisable to test pay for services options on a 
pilot basis in mature sites during the final year of the current DAP. 
In the case of PODER, the existing levels of organization and leadership within 
communities would permit CARE to transition to a facilitator role in the last year of the 
current DAP in most mature project sites. Existing levels of planning and project
management knowledge allow for a systematic transfer of responsibilities to community 
leaders. They could be responsible for organizing training activities (finding venues, hiring 
instructors, organizing logistics, identifying participants) and supervising follow-up 
activities.
48
ANNEX A: LIST OF EVALUATION SITES.
HOGASA
Aldea Ingrula, Municipio Guajiquiro, La Paz 
Aldea Santa Lucia, Municipio Santa Ana, La Paz 
Aldea Semane, Municipio Yamaranguila, Intibuca 
Aldea San Jose, Municipio San Marcos de la Sierra, Intibuca 
Aldea La Arada, Municipio Candelaria, Lempira
Aldea Quezungual, Municipio Gualcince, Lempira
EXTENSA
Aldea San Jose, Municipio Guajiquiro, La Paz
Aldea Santa Lucia, Municipio Santa Ana, La Paz
Aldea Semane, Municipio Yamaranguila, Intibuca
Aldea San Jose, Municipio San Marcos de la Sierra, Intibuca
Aldea San Francisco, Municipio Candelaria, Lempira
Aldea Gualcea, Municipio Gualcince, Lempira
PODER
49
ANNEX B: HOGASA INTERVIEW LIST.
INGRULA, GUAJIQUIRO, LA PAZ
MOTHERS FATHERS VOLUNTEERS
1.María Esmelda Hernandez
2. Rosario Marroquín
3. Rosa Idalia Marroquín
4. Lucila Corea
5. Doris Orbelina Hernandez
1. Juan Alonso Corea
2. Dora Esmeralda Vásquez
3. Maura Antonia Gomez
4. Santos Pedro Martinez
5. Elsa Perez
In Guajiquiro, Georgina Lopez, nursing auxiliary at the CESAMO in that community, was 
interviewed also.
SANTA LUCIA, SANTA ANA, LA PAZ
MOTHERS FATHERS VOLUNTEERS
1. María Petrona Granados
2. Ana Emérita Vásquez
3. Macaria Ventura
4. María Velásquez
5. Santos Margarita Vásquez
1. Efraín Vásquez
2. Cristóbal Lopez
3. Franciso Sanchez
SEMANE, YAMARANGUILA, INTIBUCÁ
MOTHERS FATHERS VOLUNTEERS
1. Emelda Ramos
2.María Ambrosia Manueles
3. Evangelista Gomez
4. Priscilia Vásquez
5. Rumalda Vásquez
1. Emiliano Manueles
2. Mario Manueles
3. Eusebio Rodríguez
4. Dionisio Lorenzo
5. José Cruz
In Yamaranguila, Daysi Margarita Pineda, nursing auxiliary at the Yamaranguila 
CESAMO, was interviewed also.
50
SAN JOSÉ, SAN MARCOS, INTIBUCÁ
MOTHERS FATHERS VOLUNTEERS
1. Marina Sanchez
2. Sandra Hernandez
3. Digna Bautista
4.Margarita Molina
5. Silveria Díaz
6. Pentecostés Lopez
7. Maria Santos Díaz
1. Esteban Cabrera
2. Manuel Lopez
3. Francisca Hernandez
4. Cipriana Pineda
LA ARADA, CANDELARIA, LEMPIRA
MOTHERS FATHERS VOLUNTEERS
1. María Arminda Díaz
2. Valeria Amador
3. Mercedes Lopez
4. Teresa Flores
1. Fermín Gomez
2. Martín Martinez
Dr. Lizeth Maribel Alfaro, sector chief for the Ministry of Health at Candelaria, was also 
interviewed.
QUEZUNGUAL, GUALCINCE
MOTHERS FATHERS VOLUNTEERS
1. Saturnina Melchor
2. Selvia Martinez
3. Rufina Marinez
4. Digna Cruz
5. Reina Vicenta Gomez
6. Concepción Castillo
1. Matias Castillo
2. Samuel Cartagena
3. José Gabriel Henriquez
4. José Luis Ortiz
51
ANNEX C: HOGASA INTERVIEW GUIDES.
MOTHERS AND FATHERS
1. In this community, do you think that there are many children with a malnutrition 
problem? Do the children here get sick a lot? Do small children, or mothers during 
childbirth, die?
2. Are there more or less children with malnutrition than 8 years ago? Do the children 
get sick more or less than 8 years ago? Change in mortality.
3. What activities have been carried out in the community to improve the health and 
nutrition situation of the children and mothers? 
4. Do you think the CARE program has helped improve the situation in some way? In 
what, especially?
5. Have you received advice about the feeding of children and mothers? From whom? 
Have you done at home what is recommended? If not, why? What has been the 
result? Do you think the advice you are given is useful? Why? Have there been 
changes in the way of feeding the children? Have you seen results in the health and 
nutrition of your children?
6. Do the fathers participate in the educational activities and in caring for the children?
How do they participate? Have there been changes in that?
7. Is the provision of foodstuffs of help in your nourishment? If you did not have the 
ration of food, would you have enough food for the family? What would you do if 
you did not have this ration? What do you plan to do when this is not given any 
more? Besides eating them, do you use them in any other way?
8. Do you know the CARE program health volunteers? Have you visited them? Have 
you taken your children to a volunteer for growth control or when sick? What do 
you think of the work they do? Is the work that they do at all useful to you? In what, 
especially? Do you think they can continue working even though CARE is no 
longer present?
9. Do you believe the community’s health program may continue working without 
CARE? In what way? How could the fathers support this program?
10. Are the products that are harvested in the parcels utilized in the family’s food? Or 
are some for sale only? Which, and why? Has the food changed in the last 8 years? 
What changes?
11. In general, what have you liked the most about CARE’s program; what has been 
most useful to you? Why? What things have you not liked or you think have not 
worked well? Why? Suggestions or changes you would like made in the program.
52
HEALTH VOLUNTEERS
1. How long have you been in the program?
2. In this community, do you think that there are many children with a malnutrition 
problem? Do the children get sick a lot here? Do small children, or mothers during 
childbirth, die? Are there now more or less malnourished children than 8 years ago? 
Do the children get sick more or less than 8 years ago? Change in mortality. What 
are the things that have most helped to improve the situation / what things have not 
allowed an improvement?
3. How do you feel within the program? Do you think that the activities carried out 
contribute to improving the health and nutrition conditions in your communities? 
Why yes, why not? In what way?
4. What has been the families’ response, do you receive support, acceptance, do you 
believe that the community thinks your work important?
5. How does the time that you dedicate to volunteering affect being able to carry out 
other activities of interest to you?
6. What do you like most of participating in this program (benefits), what have you not 
liked or difficulties you have in carrying out your activities.
7. Do the actions that CARE performs in the other 2 components (EXTENSA and 
PODER) contribute in some way to what is done for the health and nutrition of the 
children and mothers? Is what is produced in the parcels used in the families’ food? 
(diversification of diet).
8. Do you think that the food given to the families are a lot of help to them?
9. Could you continue working in this community health program even when CARE is 
no longer in the zone? If not, why? What would be the difference?
10. What is the relationship that you have with the staff of the health centers like; do 
they think your work is important? Do they support you in your activities, in what 
way?
11. Do you think that something in the Project should be modified, what aspects? Why?
12. In general, what do you think have been the main benefits in the health of children 
and mothers with the CARE program?
53
HEALTH PERSONNEL
1. As health personnel, have you been involved in the activities of the HOGASA 
component of CARE? In what actions, specifically?
2. Do you think that there has been a change in the health and nutrition situation of the 
maternal-infant population of this zone, from 1996 to this date? Why do you think 
yes or no? What factors or processes would be influencing this situation?
3. Do you think that CARE’s work has had some favorable result on the improvement 
of the health and nutrition situation of the population that has been tended?
Considera usted que el trabajo de CARE ha tenido algún resultado favorable en el 
mejoramiento de la situación de salud y nutrición de la población atendida? En que 
se ha visto el resultado?, si no porqué cree que no se ha logrado? Cómo podría 
mejorarse la obtención de resultados?
4. Como visualizan el trabajo de los voluntarios y el sistema de salud comunitaria 
como tal, como contribuye a la situación de salud y nutrición de los niños y madres, 
por qués, qué dificultades observan, qué aspectos podrían cambiarse o mejorarse.
5. Continuidad de las acciones sin CARE, como lo visualizan, desde el punto de vista 
de Salud, los voluntarios, las comunidades.
6. Qué piensa usted de la ayuda alimentaria que se da a las familias, existe mucha 
necesidad todavía de esta ayuda, es un complemento importante a la dieta?, Cómo 
sería la situación en cuanto a la alimentación de madres y niños si ya no se diera 
esta ración?
7. Que sugerencias podría hacer para el programa de Seguridad Alimentaria de CARE 
para mejorar la obtención de resultados a nivel de la población?
54
ANNEX D: EXTENSA INTERVIEW LIST.
Aldea San Jose, Municipio Guajiquiro
Antonio Sanchez Gomez
Luis Hernandez Gomez
Aldea Santa Lucia, Municipio Santa Ana
Maria Teresa Vazquez
Jose Ernesto Vazquez
Evaristo Vazquez
Jose Cruz Granados
Martin Sanchez
Marcos Granados Hernandez
Juan Pablo Bazan
Antonio Granados Bazan
Efigenio Sanchez
Aldea Semane, Yamaranguila
Angela Manueles
Pedro Vazquez
Jose Maria Vazquez
Nemesio Manueles
Aldea San Jose
Cristobal Pineda
Ramiro Gomez
Cipriana Pineda
Aldea San Francisco, Candelaria
Alejandro Cantarero
Fermina Garcia
Jose German Quintero Diaz
Genaro Callejas
Diego Martinez
Martin Diaz Callejas
Julio Martinez
Aldea Gualcea, Gaulcince
Felipe Leyva
Jose Felix Echeverria
Calixto Leyva
Camilo Avilez
55
ANNEX E: EXTENSA INTERVIEW GUIDE.
Le alcanza lo que produce su finca para lo que necesita su familia todo el año?
(follow-up questions, as required by response to determine household food security
situation)
Hace 5 años su situacion era igual?
(follow-up questions to determine specific changes in household livelihood.)
Cultiva de manera diferente ahora que 5 años antes?
(follow-up questions and visits to fields)
Vende parte de su cosecha?
(follow-up questions about marketing, roads, prices as required by response)
Y hace 5 años?
(follow-up questions as required by respose to determine changes in cash income)
Tiene usted planes para su parcela/finca para el futuro?
(follow-up questions as required to determine specific changes farmer has in mind as well 
as insights into sustainability; best done on site in the farmer’s field)
Saca usted creditos de su banco (BRHIS)?
(follow-up questions as required by response; also questions about group size and member 
turnover and women participation, depending on response)
El proyecto EXTENSA le ha ayudado en algo?
(follow-up questions to determine specifics as required by response)
Que le recomendaria para mejorar al proyecto EXTENSA?
(follow-up questions to determine specifics as required by response)