PROGRESS EVALUATION REPORT
Urban Environmental Health and Hygiene Behavior (EH) Activity
__________________
CARE/Peru Cooperative Agreement
___________________
Proyecto de Modelos Urbanos de Salud Ambiental (MUSA Project).
Fred L. Mann, USAID/Peru
Lima, Peru
May 20, 2003
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Table of Contents
Page
I. Introduction 1
II. Findings, Conclusions and Recommendations. 1
A. Overall MUSA Project. ` 1
1. Prospects for Successful Project Completion 1
2. Progress Reporting. 2
3. CDC Contributions to MUSA Planning and Implementation 4
4. Budget and Finances 4
5. Implementation Coordination and Support 5
6. Local Participation 7
7. MUSA Collaborating Institutions 8
8. Complementary Funding 8
9. Monitoring System 9
10. Direct Implementation of Pilot Project by CARE/Peru 10
B. Pilot Projects. 11
1. FOVIDA: Management Model for Water Distribution
with Tank Trucks in Villa el Salvador. 11
2. INCAFAM: Management Model for Safe and Nutritious Food
in Communal Eateries in San Juan de Lurigancho. 11
3. OACA: Management Model for Solid Waste from Health Care 
Providers-Centralized Treatment System in Collique (Comas). 12
4. LABOR: Local Participation Model for Abatement of Air Pollution
in the Cercado de Arequipa. 12
5. CIED: Local Participation Model for Solid Waste Management
in Puno. 14
2
6. CEPCO: Local Participation Model for Safe Water Supply
and Sewerage Services in Tarapoto. 14
7. CARE: Local Participation Model to Provide Safe Water
and Sewerage Utilizing the Condominial Approach in Iquitos. 15 
_____________________________
ATTACHMENTS
Attachment One: Background and Description of MUSA Project
Attachment Two: List of Acronyms
Attachment Three: List of Contacts
Attachment Four: List of Reference Documents
Attachment Five: Schedule of Briefing Meetings and Site Visits
Attachment Six: Budget Allocations, Expenditures to Date and Sub-Grant Project 
Funding Levels by Source.
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PROGRESS EVALUATION REPORT
Urban Environmental Health and Hygiene Behavior (EH) Activity
Proyecto de Modelos Urbanos de Salud Ambiental (MUSA Project)
I. Introduction.
This document reports major findings, conclusions and recommendations of the progress 
evaluation of the MUSA (Modelos Urbanos de Salud Ambiental) Project. MUSA was 
initiated on September 6, 2001 upon signing of Cooperative Agreement No.527-A-00-01-
00197-00 between USAID/Peru and CARE, and is being implemented by CARE/Peru
(assisted by other consortium members and collaborators). As the major sub-activity 
under the Urban Environmental Health and Hygiene Behavior (EH) Activity, MUSA is 
expected to make important contributions to achieving the intermediate results planned 
for Strategic Objective twelve (SO12): Strengthened Environmental Management to 
Address Priority Problems. 
Attachment one to this report provides the historical setting for MUSA, along with a brief 
description of the project. Also included in Attachment one is a statement of the scope 
and purpose of this evaluation, and of the procedures used. 
Major findings and conclusions of the evaluation are presented below, as well as related 
recommendations for consideration by the USAID/Peru SO12 team and EH partners to 
improve project implementation management and performance.
II. Findings, Conclusions and Recommendations.
A. Overall Project.
1. Prospects for Successful Project Completion.
-Findings and Conclusions.
A number of unanticipated problems have conspired to delay project progress. Many of 
the more serious problems have been resolved, and others are well on the path to 
resolution. Specific findings and conclusions below identify some problems still to be 
resolved (at the end of the evaluation period), along with recommendations that suggest 
possible approaches to their resolution.
The LTGMU (CARE/ Peru Local Technical and Administrative Management Unit of the 
MUSA Project) and staff of other consortium member institutions were very cooperative 
throughout this evaluation, and demonstrated a thorough grasp of overall project 
objectives, implementation progress and problems requiring attention. With some 
exceptions noted in later sections of this report, past performance appears to have been 
2
professional, technically sound and timely. Based on visits to all project implementation 
institutions1
 and to all seven pilot project sites,2
 this evaluation concludes that, despite 
past implementation delays, there are reasonable prospects for MUSA to achieve key 
planned results and to essentially achieve expected end-of-project status on time and on 
budget.
2. Progress Reporting.
-Findings and Conclusions.
 Quarterly progress reports are intended to record and communicate significant highlights 
of implementation progress, ongoing and emerging problems and issues, and progress in 
their resolution. These reports also should indicate the highlights of action plans for the 
ensuing quarter. These reports complement ongoing coordination communications and 
meetings among the various institutions involved in MUSA management, implementation 
and financing. Additionally, these reports are an important part of the official record of 
the project, and also should serve as a major management decision and action tool for EH 
Activity partners, especially for USAID/Peru, DIGESA and CONAM.
Both the structure and content of MUSA quarterly progress reports could be improved to 
better fulfill intended purposes. Much of the information on progress in quarterly reports 
to date uses as a reference point the activities and timetables presented in the LOP and 
annual operating plans. Timetables for achieving inputs are presented in MUSA annual 
operating plans, but not timetables for achieving intermediate project results (or of 
milestones that indicate achievement of measurable progress towards planned results). 
This gap in the chronology of results achievement carries over to progress reporting. 
Thus, the MUSA quarterly reports provide timeline information primarily on 
achievement of inputs instead of on achievement of results milestones (indicators of 
achievement of intermediate results or of progress in achieving final results). Not only 
would information on achievement of results (or results milestones) be more helpful in 
understanding progress, it also would be more helpful in anticipating and detecting 
unresolved problems or implementation issues that should be communicated to EH 
partner management personnel.
In addition to the need to develop and report progress against timetables for results, the 
progress reporting format being used (i.e., by components that cut across pilot project 
lines)3
 does not lend itself well to problem/issue discussion. Now that the pilot projects 
have been approved and funded (pending funding approval in Puno), and are being 
implemented under the leadership of their respective sub-grantees (with oversight and 
backstopping by the MUSA consortium and other partners), most significant problems 
 
1
 The LTGMU staff, MUSA Consortium partners, and all pilot project sub-grantees, as well as many of 
their respective collaborators.
2
 Collique, San Juan de Lurigancho, and Villa el Salvador in Metropolitan Lima/Callao, and four in-country 
sites in Arequipa, Iquitos, Puno and Tarapoto. 
3
 The MUSA LOP plan is formatted according to these components, and the quarterly reports are simply 
following that format.
3
and issues relate directly to a particular pilot project, rather than to a cross-cutting 
component of the overall project. Although it may be appropriate and necessary to report 
progress by component, it is even more important for consolidated quarterly progress 
reports to summarize progress towards results, and to identify emerging problems, for 
each pilot project as well.
Finally, quarterly progress reports to date include a considerable amount of detailed 
documentary material that detracts from the core results progress information that should 
be reported. Additionally, even in the executive summaries, considerable detail about 
inputs detracts from the overall presentation of significant elements demonstrating 
satisfactory results progress (and problem resolution), and/or identification of key factors 
that may impede future progress, as the case may be. Again, this appears to flow from the 
emphasis in planning documents on timetables for inputs instead of for results 
milestones.
-Recommendations.
Improving the quality and mechanisms of communication about implementation progress 
among EH Activity partners and MUSA project implementers can energize collaboration 
in facilitating and accelerating problem and issue resolution, and strengthen support for 
corrective implementation actions during the remainder of the project period. To set the 
stage and to move forward in improving progress reporting and communication, it would 
be appropriate to organize a “stock-taking” workshop in Lima to review communication 
mechanisms (especially quarterly progress reporting), and to re-examine and/or refine 
MUSA results indicators, including indicator timelines for intermediate results and for 
milestones towards final results.
The workshop should seek a common understanding of a timetable for achieving 
intermediate results and milestones for final results (as distinguished from a timetable for 
inputs). The workshop also should discuss how tracking and reporting the timeliness of 
achieving results milestones will assist in anticipating potential problems and issues, in 
order to provide to all partners the opportunity to contribute to resolution before serious 
setbacks occur. Placing potential problems on partner agendas early on often can lead to 
resolution in time to avoid significant implementation delays.
Additionally, the workshop should revisit progress reporting formats and content, 
especially for quarterly reports, in order to assure relevance and conciseness that avoids 
diluting core information with information that is better transmitted through other 
channels (i.e., technical publications, administrative documents, etc.).
It may be appropriate to subsequently organize "mini-workshops" at the four in-country 
sites for the benefit of pilot project sub-grantee interaction on these themes with CIIMSA 
associates. 
4
 3. CDC Contributions to MUSA Planning and Implementation.
-Findings and Conclusions.
The CDC (US Center for Disease Control and Prevention), through its Environmental 
Health Services Branch, has made major contributions (at no cost to the project) to 
MUSA implementation strategy, plans and progress. The effectiveness of these 
contributions was enhanced by the prior collaboration between the National Center for 
Environmental Health Services of the CDC and CARE/Peru.4
Important contributions by the CDC to MUSA have included, 1) introduction (and 
technical assistance in its adaptation) of the PACE-EH local participation action model, 
2) a model for networking (CIIMSA) to energize and channel local initiatives, 3) 
introduction and assistance in adaptation of the local environmental health risks 
monitoring system (SIMOLORSA), and, 4) other technical and organizational 
contributions. Their collaboration during the remainder of the implementation period can 
continue to backstop and motivate the various actors involved in implementation.
4. Budget and Finances.
-Findings and Conclusions.
The choice of terminology for MUSA budget categories has led to some 
misunderstanding about the proportion of total project expenditures that are for 
administrative costs. The Cooperative Agreement includes budget items for training, 
monitoring and evaluation, technical assistance and advocacy activities under the 
category of local administrative costs (administracion local). This is misleading because a 
significant proportion of these costs (perhaps 75%) are dedicated to direct project 
implementation activities, including training, institution-building and technical assistance 
for overall and pilot project implementation.
Allocations of funds for sub-grant projects appear to conform to planned amounts. The 
rate of expenditures for overall project implementation appears to be on target, while 
expenditures for sub-grant projects are behind planned expenditures. However, 
expenditures for the sub-projects most likely will accelerate over the next several months 
and can reasonably be expected to be nearly on schedule by the end of 2003. In some 
cases (e.g., the Puno project) no-cost extensions may be required to complete 
achievement of project results. Attachment Six to this report provides a breakdown of 
funds budgeted for the entire implementation period, and those expended through 
February, 2003, by overall project components. It also shows the level of funds allocated 
to each sub-project, by USAID/Peru funding, Americas Fund allocations, and other co￾financing commitments.
-Recommendations.
 
4
 This collaboration was initiated in Peru in 1999 under the CARE/CDC Health Initiative (CCHI).
5
Several line items now lumped into the category of "Administracion Local" perhaps 
could be shifted to a new line item name that better reflects the purpose of these 
expenditures (e.g., "Implementation Support"). In lieu of this (or in addition to), 
expenditures for some line items (especially LGTMA personnel costs) could be further 
sub-divided into: 1) administrative and management costs, and, 2) technical assistance 
and training services costs, in a manner that reasonably reflects their time allocations for 
each of these.
Whether or not changes are made in the format for budgeting and expenditure reporting, 
it is important for all partners to be aware that although "administracion local" does 
include administrative/management costs, the majority of the costs in this category are 
substantive project implementation services costs.
As the pilot projects progress, there will be relatively greater expenditures for sub-grants 
as compared to overall project expenditures. Nevertheless, vigilance must be exercised to 
assure that LGTMU and overall project expenditures do not exceed budgeted amounts.
5. Implementation Coordination and Support.
-Findings and Conclusions.
MUSA was initiated under the SO4 SOAG. That SOAG designated DIGESA as the 
official GOP representative for all EH activity initiatives. Upon signing of the SO12 
SOAG in September 2002 (replacing the SO4 SOAG), CONAM became the official 
GOP representative for the EH Activity. DIGESA was specified to continue to be 
responsible for technical and management aspects of EH Activity implementation under 
the terms of a sub-agreement to be entered into between DIGESA and CONAM. As a 
part of that agreement, funds for EH Activity management by DIGESA were to be 
disbursed by CONAM to PAAG (an organization attached to the MINSA Direccion 
General de Salud Publica that has authority to administer international technical 
cooperation funds). Under the sub-agreement, PAAG receives disbursements from 
CONAM. PAAG, in turn, is responsible for making expenditures to and on behalf of 
DIGESA to carry out its responsibilities under the EH Activity. This includes payment of 
personnel compensation and operating costs of the Unidad Coordinadora de la Actividad 
(UCA), the unit in DIGESA responsible for coordinating and facilitating implementation 
of EH activity projects and programs (i.e., MUSA). These coordinating and facilitating 
functions include coordination with DIGESA management and other public sector 
agencies as appropriate, facilitating and backstopping public health sector support and 
involvement in MUSA activities at national and pilot project levels, and facilitating 
DIGESA approvals of MUSA and pilot project implementation documents, including 
technical, planning and procedures documents.
Throughout the period of MUSA project implementation to date, frequent turnovers of 
DIGESA management leadership have occurred. This has led to failure to provide timely 
responses to issues formally raised by USAID/Peru concerning disbursement 
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arrangements. Because of this, USAID/Peru has been unable to authorize disbursement 
by CONAM of USAID funds to PAAG. There remain several months of pending 
payments for UCA personnel compensation and other related EH Activity costs. These 
problems have contributed to delays in MUSA project implementation. Additionally, 
considerable time of the MUSA project team (and of UCA staff) has been dedicated to 
briefing new DIGESA leadership and in achieving their cooperation to facilitate technical 
and administrative actions and approvals required.
During the period of the evaluation, there were indications that internal problems in 
MINSA/DIGESA/UCA mentioned above were being resolved. Nevertheless, it is not yet 
certain that these organizations will have the continuing stability and commitment needed 
to facilitate and assist in accelerating MUSA throughout the remainder of the 
implementation period. Effective collaboration by all public sector counterparts is critical 
to completing the pilot projects on schedule.
-Recommendations.
Timely GOP implementation coordination is a pre-condition to satisfactory MUSA 
project implementation. Not only must funds be disbursed in a timely fashion to allow 
DIGESA-UCA to support and facilitate MUSA implementation, both in Lima and at in￾country project sites, timely technical approvals and administrative actions by DIGESA 
also are essential to maintain the MUSA implementation schedule. These externalities are 
largely beyond the purview of the LGTMU, the MUSA consortium and pilot project sub￾grantees.
It is important for primary project partners to develop rapid response arrangements to not 
only brief new leadership when turnover occurs, but also to renew with them ongoing 
institutional agreements and commitments for continued support. When there is a 
turnover of leadership at a particular level in a particular institution, all other partners 
should collaborate in arranging and participating in early face-to-face briefings and 
"recommitment" meetings. Participants in such meetings should include persons from 
partner institutions that are at an equivalent hierarchical level to the new leadership being 
briefed. It is especially important that USAID (and CONAM) equivalent leaders 
participate in order to provide legitimacy and status to the presentation. Experience has 
shown that it is difficult to bring new leadership on board through briefings by technical 
and implementation level actors. Resolution of and/or reinforcement of the urgency of 
resolving pending problems/issues in this respect may require communications and 
meetings at vice-ministerial/ministerial levels. 
Current arrangements for funds disbursement from SOAG funds for support to DIGESA 
(and UCA) appear to be unnecessarily complex. Nevertheless, with adequate 
commitment by MINSA and DIGESA leadership, the arrangements should be able to 
perform satisfactorily. If such commitment is not forthcoming in the short term (and if 
this is not demonstrated in terms of both timely funds disbursement and acceleration of 
administrative approvals), USAID and CONAM, as signatories to the SO12 SOAG, will 
need to arrange alternative mechanisms for funds disbursement, as well as for GOP-
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supplied technical and administrative support and approvals required for timely MUSA 
and pilot project implementation.
6. Local Participation.
-Findings and Conclusions.
An essential dimension of the CDC PACE-EH model being adapted to pilot project areas 
is local participation. An important vehicle to facilitate local participation has been 
formation and motivation of CIIMSA’s (Comites Inter-Institucional de Mejoramiento de 
Salud Ambiental) in each pilot project area. A CIIMSA is composed of local 
representatives of public sector institutions that have a local presence and that have an 
interest in EH, as well as of similarly interested local private sector groups. Another 
important vehicle to establish participation linkages of the CIIMSA to neighborhoods and 
families is through identification and training of voluntary neighborhood promoters, who 
dialogue with and inform their neighbors about EH concerns, and these also participate in 
the CIIMSA.
CIIMSA’s and voluntary neighborhood promoters have been established in each pilot 
project area. Participants in CIIMSA’s are trained and assisted to work towards 
development of long-term strategic and operational plans (i.e., EH targeted locality-based 
EMS plans), and these undertakings are enriched by and communicated to neighborhood 
families through voluntary EH promoters. This strategic planning process can be 
expected to help motivate CIIMSA members and promoters to continue to be active 
beyond the life of MUSA pilot project interventions.
Active participation in the CIIMSA by regional DESA’s and by local municipalities 
facilitates incorporation of elements of CIIMSA-generated long-term strategic and 
operational plans (or compatible plans) into their respective institutional plans, which in 
turn becomes an important factor in sustaining the CIIMSA and neighborhood promoters 
as active networking elements.
As developed by CDC and adapted under MUSA to local conditions, CIIMSA’s become 
sponsors of a process that begins with a participatory diagnostic to identify and prioritize 
local EH risks, and eventually leads to development and application of an ongoing local 
EH risk monitoring system (known as SIMOLORSA), to help understand and quantify 
over time the beneficial impacts of local initiatives to improve EH (and to stimulate 
continued dynamism of the CIIMSA process).
CIIMSA’s and voluntary promoters are in place and operating at varying levels of 
consolidation and effectiveness in all pilot project areas. Although their long-term 
viability is not yet assured, the level of interest and participation demonstrated in all pilot 
project areas is highly encouraging. Successful pilot project completion should help 
assure that participants in this networking system will remain active in EH risk 
monitoring and in sponsoring other local EH improvement projects.
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-Recommendation.
The experience under MUSA of applying the PACE-EH local participation model may 
provide valuable lessons learned that could be of utility in other USAID/Peru activities. It 
is suggested that opportunities be generated for interaction and information exchange 
between the MUSA project implementation team and implementers of democracy and 
alternative development activities that could or should mobilize local participation for 
achieving intended results.
7. MUSA Collaborating Institutions.
-Findings and Conclusions.
In addition to the three CARE/Peru consortium members, two collaborating institutions 
with regional headquarters offices in Lima were included in the MUSA proposal: the 
World Bank/UNDP Water and Sanitation Program (WSP), and the PAHO Center for 
Sanitary Engineering and Environmental Sciences (CEPIS). The WSP has provided 
engineering and social sciences expertise related to the so-called condominial system for 
community water and sewage systems (based on successful applications in Bolivia). 
Similarly, CEPIS has provided engineering expertise in appropriate technology for small 
water treatment and supply, and small sewage treatment systems. These have been 
important technical contributions to the design of the small water and sewage systems 
being implemented under two pilot projects (in Tarapoto and Iquitos).
8. Complementary Funding.
-Findings and Conclusions.
Approximately two-thirds of USAID funding for MUSA is budgeted to finance pilot 
projects, through sub-grants to competitively selected NGOs for six projects and through 
direct implementation by CARE/Peru for one project. In the LOP plan, it was anticipated 
that some complementary funding would be leveraged from local sources in pilot project 
areas.
In carrying out the competitive process for selection of sub-grantees for the special 
innovation pilot projects in metropolitan Lima, it became apparent that available USAID 
funds were inadequate for financing them. The choices were to reduce the number of 
projects or leverage additional funding. With USAID assistance, arrangements were 
made with the Americas Fund to co-finance these three projects. This co-financing 
arrangement required considerable mutual effort to adapt the competitive sub-grant award 
process to both USAID and Americas Fund procedures, causing some delays in selection 
and training of sub-grantees. However, not only did this co-financing arrangement result 
in leveraging approximately 40% of the total cost of these three projects, it also was the 
first experience by the America's Fund in co-financing. Thus, procedures now have been 
tested for possible future co-financing in replications of validated local project models 
resulting from MUSA pilot project experiences.
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Additionally, the pilot project implemented directly by CARE/Peru was successful in 
leveraging nearly 75 % of total project costs. These funds come from a variety of sources, 
including the bi-national fund, the Municipality of Maynas, and the Programa A Trabajar 
Urbana.
These are valuable leveraging experiences that can be instructive for arranging financing 
for future local EH projects that replicate the models validated by MUSA.
9. Monitoring System.
-Findings and Conclusions.
During preparation of the MUSA LOP plan, a plan for monitoring pilot projects was 
developed and approved. DESCO, the MUSA consortium member responsible for 
applying this pilot project monitoring plan, has expended considerable effort in 
developing software for automation of the local monitoring system. Additionally, 
SIMOLORSA, mentioned above, is being incorporated into the local CIIMSA 
undertakings. Baseline surveys for SIMOLORSA have been completed in some pilot 
projects, and are nearly ready to be carried out in the others.
Because pilot projects are just now beginning to be implemented, the practicality and 
effectiveness of the automated monitoring system that has been developed by DESCO 
has not yet been validated. Monitoring plans are a mandatory component of all USAID 
financed projects. Yet practical successes in automating project monitoring systems are 
scarce. Without special attention, the MUSA automated pilot project monitoring system 
could encounter difficulties in terms of practical application and generation of 
meaningful results.
-Recommendation. 
Automation of practical monitoring systems is a rather complex undertaking that requires 
specialized expertise. Likewise, evaluation of a planned system requires specialized 
expertise (that is not a part of this evaluation). Nevertheless, past experience suggests that 
the risk of achieving less than satisfactory results is rather high. For this reason, it is 
suggested that it may be appropriate for USAID to sponsor some type of workshop in 
which various partners responsible for developing and applying automated (or non￾automated) monitoring systems in all USAID-financed activities can share experiences 
and progress. This may assist many participants in the workshop, including DESCO, to 
avoid pitfalls, and to achieve practical applications that serve their intended purposes 
within programmed time frames.
10. Direct Implementation of Pilot Project by CARE/Peru.
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-Findings and Conclusions.
The Cooperative Agreement specified that CARE/Peru would directly implement the 
pilot project in Iquitos. This pilot project already had been designed and promoted with 
other funding by CARE/Peru in partnership with the CDC. There was a convincing logic 
to implement this project with USAID funding support in order to capitalize on progress 
already made and to provide the opportunity to transfer information on lessons learned 
therein to other pilot projects.
A number of factors related to local political instability and EH-related leadership 
changes in Iquitos caused unexpected delays in project implementation, and required a 
considerable amount of special effort and time of the LTGMU staff to resolve. 
Fortunately, as indicated below, those problems seem to have been resolved, and project 
implementation is proceeding at an encouraging pace.
Implementation of the EH education plan in this pilot project is worthy of special note. 
The approach and materials prepared appear to be quite successful in mobilizing interest 
and transferring knowledge, and voluntary EH promoters and block delegates appear to 
be active and effective in transferring their know-how. 
The need to concentrate effort by LGTMU management and technical staff to get the 
Iquitos pilot project back on track may have absorbed backstopping assistance capability 
needed by the other pilot projects. Some of the problems that occurred to cause delays in 
other pilot projects (mentioned below) might have been resolved in a timelier manner if 
more LGTMU staff time had been dedicated to their resolution. Of course it is fully 
within the management purview of LGTMU to allocate staff time as it considers 
necessary. However, direct implementation of a pilot project presents pressures for (or 
appearances of) placing a higher priority on the needs of the directly implemented project 
at the expense of sub-granted projects. This is not to say that such is the case.
-Recommendation.
Special care should be taken by LGTMU management and by the USAID manager to 
assure that there is not an allocation of (or appearance of allocation of) LGTMU staff 
time to the directly implemented pilot project in disproportion to that dedicated to sub￾grant pilot projects.
Additionally, from the MUSA experience, there should be lessons learned for transfer to 
other ongoing and future pilot projects and for future project design where sub-grants are 
involved. With respect to the first point, consideration should be given to transferring the 
lessons learned in carrying out the education program in Iquitos to Tarapoto (which is 
less advanced in implementation). An exchange of training personnel for this purpose 
could be quite effective in enhancing the effectiveness of the Tarapoto educational 
program.
B. Pilot Projects.
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Each of the pilot projects is briefly summarized in Attachment One. Although timetables 
for implementation of all pilot projects are behind schedule, if lessons learned to date are 
incorporated into the implementation process (and in the absence of major unanticipated 
future setbacks), progress performance can be accelerated in order to "catch up". Thus, 
there are reasonable prospects for satisfactory completion of all pilot projects by the end 
of their respective implementation periods. Further, sufficient additional time remains in 
the overall MUSA project period to permit short no-cost extensions, if justified.
Major findings, conclusions and recommendations for each pilot project are summarized 
below.
1. FOVIDA: Management Model for Water Distribution with Tank Trucks in Villa El 
Salvador.
The NGO sub-grantee for this project has been working in the project area for several 
years, and was able to quickly establish rapport and to achieve widespread local 
participation. Additionally, the sub-grantee has an excellent grasp of the problem set 
being addressed by the project, and understands the changes required for solution. 
Additionally, key local actors have been incorporated as strategic partners in resolving 
the problems. Nevertheless, end-of-project results need to be revisited, especially since 
there are a number of levels of actors that must change behavior, and in some cases 
significant investments will be required that is not available from the sub-grant.
A mini-workshop (as suggested above) to revisit and refine project results and milestones 
could be a key input into satisfactory project completion.
2. INCAFAM: Management Model for Safe and Nutritious Food in Comunal Eateries in 
San Juan de Lurigancho.
The NGO sub-grantee in this case has several years of experience in working with 
families in the project area. It was able to quickly generate baseline information, achieve 
widespread local participation, and to form strategic alliances with key local actors. 
There is every indication that this project should be able to proceed according to plan and 
show planned end-of-project results. Potential problems could arise if restricted current 
food distribution by PRONAA becomes even more restricted or less reliable if and when 
warehousing and distribution is turned over to municipalities, as apparently is planned.
Further, even though the safety of food handling most likely will be marginally improved 
in the model communal eateries, replicability without relatively intense NGO 
involvement may be problematic. Also, although outside the purview of the project, EH 
conditions can only improve marginally through these types of actions in the absence of 
improved economic conditions of the most marginalized of families that are the intended 
beneficiaries of the pilot project.
3. OACA: Management Model for Solid Waste from Health Providers-Centralized 
Treatment System in Collique (Comas).
12
The engineering aspects of this project appear to be well in hand, although some 
treatment plant capacity decisions are still pending (at the end of the evaluation period). 
The marketing study has only recently been completed and must still be reviewed by 
interested parties. A quick review indicates that it has at least touched the important 
aspects of a business plan for the treatment plant, and provides a meaningful basis for 
final decisions on an action and business plan for facility construction and operation.
The project is much more complex than it appears on the surface. Successful completion 
depends greatly on the ability of the host institution (Hospital Sergio Bernales) to fulfill 
its commitments, which are considerable, not only for project startup, but also for 
continued successful operation. This project well may need more time for completion, 
beyond the current June 2004 completion date.
A group dynamics mini-workshop (suggested in a previous section) that reviews and sets 
a timetable for results and reconfirms commitments could be an excellent vehicle to 
strengthen prospects for successful completion of this pilot project.. 
4. LABOR: Local Participation Model for Abatement of Air Pollution in the Cercado de 
Arequipa.
Many of the air pollution problems being addressed by this project lend themselves only 
marginally to local action for solution. The project does not pretend to be able to 
significantly abate local air pollution. Rather it seeks to create the conditions for initiating 
a process that results in cleaner air (and in other improved EH conditions) in the longer 
run. To achieve this, among other things, it seeks to demonstrate technological changes 
(e.g., vehicles that burn clean fuel; better mechanical adjustment of diesel engines) and 
local actions (planting trees and establishing green areas) that, when replicated on a 
massive scale, will result in significant abatement.
Of all the pilot projects, this project has the least expectation of actually significantly 
changing targeted EH conditions within its selected site. Nevertheless, it does hope to 
generate a demand for changes that, if and when implemented, can have a significant 
positive effect on air pollution within the cercado.
Local action committees in selected neighborhoods have been formed and are active, 
good will and cooperation have been developed among a number of actors through the 
CIIMSA that has been established, and strategic alliances have been formed and are 
initiating actions that demonstrate how to reduce toxic emissions (e.g., with a private bus 
company).
Nevertheless, the primary cause of air pollution, vehicle emissions, requires solutions that 
are not local in scope, decision capacity or resources. Local demand can help to motivate 
serious efforts to address air pollution at a more global level. A major option--rerouting 
of traffic--requires transportation planning on a much larger scale. Conversion of vehicles 
to less polluting fuels requires major investments by the public and private sectors, plus 
13
enforceable regulation. These are far beyond the leveraging capacity of project funds or 
of the neighborhoods being mobilized. Even neighborhood level actions in the selected 
areas (increasing green areas, tree planting and other local initiatives) are of a scope that 
dwarfs limited project resources.
In important ways, this project seeks end results beyond the intended scope of the MUSA 
model for mobilizing local action to solve local problems. Rather, it can be expected to 
mobilize local action as an initial step to sway a much larger population and geographic 
area, and a much more diverse set of interest groups to insist on global investments and 
changes required to achieve the overall objective, i.e., major abatement of air pollution. 
This project does have an 18 month implementation period, whereas the other sub-grant 
projects have a 12 month implementation period. The additional time may permit 
additional progress in achieving formal commitments for the broader changes sought, 
such as rerouting of traffic, and conversion of a significant number of taxis to cleaner 
fuels. 
A danger in local mobilization under the conditions in Arequipa, i.e., to address a set of 
problems far beyond local scope and capacities to significantly impact, is that 
expectations will be raised that cannot be met, and frustration (even backlash) can occur 
as results are not forthcoming.
Given that this project is well under way, and the preparatory stages appear to have been 
and are being successful in raising awareness and in sensitizing and educating the local
public, as well as a broader coalition of actors, it should be pursued to completion. 
However, a preferred strategy may be to seek to focus the forces being mobilized on 
informational "lobbying", i.e., generating the analytical basis for arguments that resonate 
not only with municipal authorities, but also with regional and national authorities and 
with those institutions that can assist in obtaining major resources to invest in larger scale 
air pollution abatement solutions.
In this respect, a major potential benefit from abatement of air pollution in the cercado 
has not yet been researched nor have convincing arguments been marshaled, i.e., major 
economic benefits from significant abatement in air pollution within the cercado. For 
example, what are the positive effects on tourism levels of being able to advertise the 
cercado as a clean and healthy place to be (rather than having the Department of 
Arequipa declared to be in environmental crisis, as is now the case)? Additionally, the 
direct social and private savings from reduced respiratory and allergic illnesses, both in 
terms of reduced health care costs and in increased human resource productivity, should 
make major public and private sector investment more attractive. 
5. CIED: Local Participation Model for Solid Waste Management in Puno.
This project has a scope that is within the capacities of local action, but nevertheless 
needs the strong support of the municipality to be successful. This support must be in 
terms of solid waste disposal facilities, as well as modernization and enforcement of 
littering ordinances and waste disposal regulations, (and probably of “wholesale” levels 
14
of transport as well). Additionally, there are many dimensions of solid waste management 
requirements that affect the project sites, but are beyond the scope of the project. For 
example, serious actual contamination of the Titicaca bay with solid waste stimulates the 
growth of a plant called "lenteja de agua", which apparently assists in cleaning and 
purifying the water. There has been experience in other countries of establishing an 
animal feeds industry around the harvesting and processing of this plant. The project at 
best might encourage public authorities and private interest groups to pursue viable 
options of this kind by collecting and sharing information about this and other possible 
environmental improvement opportunities that contribute to increased employment and 
economic development.
The CIIMSA in Puno is quite active, the municipality strongly supports the project, and 
there is active local participation by several community groups. USAID/Peru has not yet 
approved this project for receiving USAID funds. That approval is subject to a redesign 
that conforms to the priorities set by the PIGARS that is being prepared and is scheduled 
for completion in June. It is not clear why preparation of the PIGARS is only now getting 
under way, since this always was a prerequisite for pilot project funds disbursement and 
implementation. 
Assuming that the PIGARS is completed and adopted on schedule, and the Puno project 
is quickly adjusted as necessary to conform to its priorities, this project should be capable 
of rapid implementation. The LGTMU should provide all possible assistance to 
accelerate completion of the PIGARS, and to assure conformance of the pilot project to 
the approved PIGARS, in order that implementation can proceed. Some no-cost 
extension of the termination date may be in order. 
6. CEPCO: Local Participation Model for Safe Water Supply and Sewerage Services in 
Tarapoto.
Pilot project implementation was delayed because after organizing and mobilizing 
initially selected target communities to participate in the project, it was learned that 
resolution of legal ownership issues related to the occupied land by the target community 
families could be indefinitely delayed. Eventually, another target area was selected. 
During the evaluation site visit, it was confirmed that the sub-grantee has a good grasp of 
the project and is providing effective leadership, local participation and mobilization is 
high (with a commitment by the communities to provide the unspecialized labor required 
for project construction), the CIIMSA is working well, the municipalities involved are 
quite supportive, and the regional DESA is actively participating in the local EH risk 
assessment (and desires to be involved in subsequent monitoring).
The engineering design for an innovative appropriate technology water treatment plant is 
complete. The DIGESA engineer who reviewed the engineering plan stated that it has 
been approved by DIGESA management, and assurances were made that the formal 
approval letter will be received by USAID momentarily.
From all appearances, this project has recovered lost time, and can be completed on time 
and on budget.
15
One aspect of the project that is not clear (which also needs clarification for the Iquitos 
project referenced below): How will the local water system be managed once the 
construction is complete? Apparently not much attention has been given to this aspect. It 
seems that the system will become the patrimony of the local state-owned water company 
and that the continuing role of the communities that made it happen will be minimal (i.e., 
a traditional client relationship to the state water company). If this occurs, it may be a 
missed opportunity to experiment with some form of mixed ownership, where the 
community (through a legal means to be explored) owns and operates the distribution 
system within the respective community, and the water company owns and operates the 
water supply facilities (i.e., it becomes the water wholesaler). This would permit the 
community to remain actively involved, but not be burdened with managing something 
that may be too technically, financially and administratively complex. 
7. CARE: Local Participation Model to Provide Safe Water and Sewerage Utilizing the 
Condominial Approach in Iquitos.
As explained above, this project was being developed when MUSA was initiated. After a 
number of delays that appear to have been caused by local political and leadership 
changes, construction has started and should be completed by September 2003. Local 
participation is high, the DESA, and mayors (provincial and district) are supportive, and 
the provincial municipality is providing significant funding. CIIMSA is quite active, and 
the Programa A Trabajar Urbana is paying community laborers for their work.
In the absence of new unanticipated problems, there is no apparent reason why this 
project should not achieve the planned results within the time period specified. (Also see 
the comment in the previous section related to post-project facility management and 
operation options).
File: Fplima001/ENR/FMann/MUSA Progress Evaluation Consolidated Report 8-19-2003
16
1
ATTACHMENT ONE TO PROGRESS EVALUATION REPORT
______
 USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
__________________________
BACKGROUND AND DESCRIPTION OF MUSA PROJECT
May 20, 2003
Lima, Peru
TABLE OF CONTENTS
Page
I. Background 1
A. Historical Perspective 1
B. The MUSA Project 2
II. Purpose of Progress Evaluation. 5
III. Summary Description of Planned Overall Training,
 Institution-Building and Monitoring Components. 5
IV. Summary Description of Pilot Projects 6
A. Special Projects in Poor Peri-Urban Areas of Metropolitan Lima. 6
1. Management Model for Supply of Water for Human Consumption
 by Tank Trucks 6
2. Management Model for Safe Food Handling in Comedores Populares 7
3. Management Model for a Centralized Treatment System for Solid Wastes
 Generated by Health Care Establishments 8
B. Integrated Local Management Projects. 8
1. Abatement of Air Pollution in the Cercado of Arequipa 8
2. Solid Waste Management in Puno 9
3. Safe Water Supply and Sewerage Services in Tarapoto 10
4. Provision of Safe Water and Sewerage Utilizing the Condominial
 Approach in Iquitos 10
V. Evaluation Procedure. 11
2
BACKGROUND AND DESCRIPTION OF MUSA PROJECT5
I. Background.
A. Historical Perspective.
In 1995, USAID/Peru funded a comprehensive study from which a Mission 
Environmental Strategy (MES) was developed. This MES became the basis for 
formulation of the initial USAID/Peru Environmental Strategic Objective of "improved 
environmental management of targeted sectors", adopted in 1996 as SO4. That same 
year, the SENREM (Sustainable Environmental and Natural Resources Management) 
project was approved and funded. In 1997, a Comparative Risk Assessment (CRA) for 
health, funded under SENREM, identified and prioritized environmental health risks in 
metropolitan Lima, and subsequently analyzed additional environmental health problems 
with high-risk impacts in poor peri-urban populations of metropolitan Lima and other 
major cities of Peru. Based on these analyses, and drawing on worldwide experiences in 
addressing environmental health risks in poor neighborhoods, USAID/Peru, with 
technical assistance from the EHP, designed the Urban Environmental Health and 
Hygiene Behavior Activity (EH Activity) as one of three major activities (one being 
SENREM) under SO4. The EH Activity was approved for funding in FY1999. Initial 
funding for implementation became available in FY2001. The EH activity was 
incorporated into the new Strategic Objective Grant Agreement (SOAG) No. 527-A-00-
01-00197-00, signed on September 6, 2002 to support achievement of the revised 
FY2002-2006 USAID/Peru Environmental Strategic Objective 12 (SO12).6
In response to CRA findings, the overall EH Activity purpose was to reduce health risks 
in selected poor peri-urban areas caused by exposure to locally generated contaminants 
and pathogens, and in the process, to test and validate appropriate urban environmental 
health local-participation models for replication throughout Peru. To achieve the Activity 
purpose, four categories of interventions were specified:
-Policy improvement assistance to Government of Peru (GOP) agencies responsible for 
environmental health;
-Site-based pilot projects to formulate, validate and demonstrate innovative ways to 
address priority environmental health needs in poor peri-urban communities;
-Technical assistance, training and institutional strengthening related to environmental 
health;
-Development of environmental health risk monitoring capacities based on community 
involvement. 
 
5
 Information in this document is based on conditions as of May 20, 2003.
6
 SO12: "Strengthened Environmental Management to Address Priority Problems." 
3
 
The SO12 SOAG designates CONAM (Comision Nacional del Ambiente) as the primary 
public sector partner to USAID/Peru for funds administration and oversight of GOP 
commitments there-under. This includes GOP commitments under the EH Activity. 
Additionally, DIGESA (Direccion General de Salud Ambiental of the Ministry of Public 
Health-MinSa), the national level GOP agency primarily responsible for environmental 
health, is designated as the public sector partner to provide technical support in 
implementation of the EH Activity. 
EHP was selected to provide specialized technical assistance to backstop DIGESA and 
others in implementation of the EH Activity, especially as related to improving 
environmental health policies, and applications thereof to local problems. A Request For
Application (RFA) No. 527-01-A-004 was issued in November 2000, to select an 
institutional contractor to establish a local grants training and management unit 
(LGTMU) to provide management leadership for developing and implementing the latter 
three interventions specified above. Under the RFA, $2,530,000 in grant funding was to 
be made available to the LGTMU for these purposes. A major portion of these funds 
were earmarked for small grants to local NGO's to plan and implement site-based pilot 
projects.
B. The MUSA Project.
A consortium led by CARE/Peru was selected from among three respondents to the RFA. 
USAID/Peru awarded a Cooperative Agreement to CARE on September 6, 2001 to 
implement the Urban Environmental Health Models Project (MUSA),7
 a three-year
project planned for completion on September 30, 2004.
The CARE/Peru consortium includes two national-level Peruvian NGO's and one US 
public sector agency: INFORMET-Information and Methodologies for Organizational 
Development, DESCO-Center for Development Studies and Promotion, and the CDC-US 
Centers for Disease Control. Other designated collaborating organizations were DIGESA, 
World Bank/UNDP Water and Sanitation Program (WSP), and the Pan-American Health 
Organization's Center for Sanitary Engineering and Environmental Sciences 
(PAHO/CEPIS).
Upon signing of the Cooperative Agreement, CARE/Peru established the LGTMU to 
assume administrative, technical and management leadership of MUSA. INFORMET 
was assigned major responsibility for planning and implementing the overall MUSA 
training program, and DESCO was made responsible for designing, applying and 
validating the MUSA project monitoring plan (PMP) to monitor progress of local pilot 
projects and also to monitor local environmental risks before, during and after pilot 
project implementation. The CDC agreed to provide technical assistance related to 1) 
models for community action in addressing locally generated peri-urban environmental 
health problems, including local risk monitoring protocols, and, 2) innovative 
 
7
 Modelos Urbanos de Salud Ambiental-MUSA 
4
technologies, especially for pilot projects to address special high priority environmental 
problems in metropolitan Lima/Callao.
Preparation of the MUSA life-of-project (LOP) plan was completed and approved in 
December 2001. Adjustments to the EH Activity, the RFA and the Cooperative 
Agreement, were agreed upon in the approved LOP plan.
The LOP plan called for development and validation of practical citizen-based urban 
organizational and action models for improving environmental health conditions, through 
seven community-level pilot projects. These pilot projects are funded through the sub￾grants program administered and managed by the CARE/Peru LGTMU. The pilot 
projects are implemented through competitively selected local NGO sub-grantees that 
develop strategic alliances with and networks of local organizations. Local municipalities 
are intended to be key actors and participants in these alliances/networks.
Capacities of the selected NGOs to lead implementation of these pilot projects were to be 
strengthened through comprehensive technical and management training by INFORMET 
and CARE/Peru. Additionally, DESCO was charged with taking the lead to develop and 
assure effective application of an integrated monitoring system to track pilot project 
progress, problems and solutions, and to monitor local environmental risks before, during 
and after pilot project implementation. The end purpose of the monitoring system is to 
validate processes, results and effectiveness of the various adaptations of organizational 
and action models applied.
Pilot projects receiving small sub-grants are expected to achieve improved environmental 
health conditions, and equally importantly, are intended to adapt and validate for 
replication practical models of organizational and operational arrangements that assure 
successful achievement and post-project sustainability of EH improvement undertakings 
in and by target communities. Thus, key products at the end of the activity are to be 
validated practical model variants for sustainable community organization and action in 
reducing locally generated and self-prioritized environmental health risks. These 
validated model variants, and the supporting action networks of public and NGO 
institutions established under MUSA, are to be incorporated into protocols and operations 
manuals that facilitate (provide roadmaps for) replications in poor peri-urban 
communities throughout Peru.
Five different environmental health problems were identified (based on the health CRA 
and follow-up studies and surveys) to be of highest priority in poor peri-urban 
communities. Each is addressed by at least one of the seven pilot projects:
1. Safe water supply;
2. Disposal of human waste;
3. Management of solid waste;
4. Safe food handling;
5. Abatement of air pollution. 
 
5
Under the LOP plan, seven local community-participation pilot projects are to be 
implemented through NGO sub-grantees that form and provide leadership to action 
networks and alliances with local public and private sector institutions and organizations 
for pilot project design and implementation. Two types (or categories) of pilot projects 
are identified under the LOP Plan for sub-grant support:
1. Special (Technical Innovation) Projects. Three projects were designated by DIGESA, 
in consultation with the USAID/Peru SO12 team and the CARE/Peru consortium, as high 
priority to validate public health technological and regulatory (policy) innovations, to 
facilitate resolution of identified priority problems through local action initiatives. These 
were to be located in poor peri-urban areas of metropolitan Lima/Callao.
2. Integrated Local Management Projects. Four projects, one each in Iquitos, Tarapoto, 
Arequipa, and Puno, are identified in the LOP Plan, each to address a selected local 
priority EH problem. Each project is to be implemented within the framework of the so￾called PACE-EH model (Protocol for Assessing Community Excellence in 
Environmental Health). The PACE-EH model was developed and applied in the US by 
the CDC (beginning in 1995), and the community environmental health assessment 
aspects of the model were adapted and field-tested by CDC and CARE/Peru in two 
Peruvian communities during 1999 and 2000. The integrated local management projects 
are intended to adapt and apply the overall PACE-EH model to their local conditions, and 
to generate know-how for replication.
The PACE-EH model consists of an iterative process that facilitates local identification of 
environmental health issues, determination of environmental health priorities by the 
affected community, development of plans for action by local-interest networks. 
Additionally, it provides a procedure to monitor progress and results of actions taken. It is 
an integrated management model centered on developing local understanding of local 
environmental health problems and priorities, stimulating local initiatives in addressing 
them, and, perhaps even more important to sustainability of local action, a system of 
continuous monitoring of EH risks so local leaders and citizens are aware of the 
community health benefits achieved as a result of their efforts. This model represents an 
application to environmental health problems of the "locality-based environmental 
management systems (EMS) approach", which is the central thrust of the SO12 strategy.8
The LOP plan calls for three pilot projects that adapt the PACE-EH model to local 
conditions and idiosyncrasies. These adapted models are to be applied under the 
leadership of competitively selected NGO sub-grantees. Sub-grantees are to identify, 
organize, motivate and provide such leadership to action alliances and interest-group 
networks of participating local organizations, institutions, and community groups 
(including municipalities) for addressing locally-prioritized EH problems. Additionally,
sub-grantees are to incorporate and cause implementation of the local EH risk assessment 
and monitoring system which is an integral part of the PACE-EH model. Within MUSA, 
this system is known as SIMOLORSA (Sistema de Monitoreo Local de Riesgos de Salud 
Ambiental). 
 
8
 Locality-based EMS is a central concept for application in achieving major intermediate results of SO12.
6
The fourth pilot project specified in the LOP plan is a project in Iquitos that already had 
been initiated under the leadership of CARE/Peru. The Iquitos project continues to be 
implemented directly by CARE/Peru, and also applies the PACE-EH model.
II. Purpose of Progress Evaluation.
This evaluation assesses general progress and performance at approximately 19 months 
after initiation of the 37 month LOP Plan implementation period. This is NOT a technical 
or financial performance audit. Rather, its purpose is to assist USAID, CARE/Peru and 
other partners to assess overall progress to date, to provide an overview of the current 
status of project implementation as compared to planned status, to identify major 
continuing problems if any that may impede future timely progress toward expected end￾of-project results, and to suggest appropriate near-term actions and/or adjustments (if 
any) that may improve prospects for achieving planned results, including adjustments in 
expected results, if appropriate. The evaluation also discusses past and probable future 
impacts of other elements of the EH Activity (and other externalities) on MUSA 
implementation.
III. Summary Description of Planned Overall Training, Institution-Building and 
Monitoring Components.
A major share of human and financial resources of the MUSA consortium is targeted to 
training, institution building, and implementation monitoring activities. Relevant 
planning and progress reporting documents provide detailed information about these 
components of MUSA. Highlights are briefly summarized below.
The LOP plan proposes several workshops to train potential NGO sub-grantees and 
partners in the design and development of proposals for pilot projects. These are to take 
place prior to the call for proposals. Several more workshops were planned to enhance 
the management capacities of the NGO's that are competitively selected to implement 
pilot projects. Additionally, continuing training programs are planned to facilitate local 
advocacy for improving EH, generation and dissemination of EH information, and 
establishment and consolidation of action alliances and EH networks. These continuing 
training activities are planned over the period of pilot project implementation.
Within the consortium, INFORMET has assumed primary responsibility for training 
related to proposing, designing, organizing and implementing pilot projects. Training 
related to technical aspects of MUSA is the responsibility of CARE/Peru, and training 
related to monitoring aspects is the primary responsibility of DESCO.
7
IV. Summary Description of Pilot Projects.
All but one of the pilot projects are being implemented through sub-grants to 
competitively selected NGOs. Appropriate agencies of the Ministry of Public Health 
(Minsa) are committed to assist in project implementation within their respective areas of 
competence. At the national level, this includes the Direccion General de Salud 
Ambiental-DIGESA, which is an SO12 public sector partner receiving direct assistance 
under the EH Activity, and the Direccion General de Salud de Personas (for one pilot 
project), responsible for public hospitals, clinics and health posts (among other 
responsibilities).
At regional levels, the respective regional environmental health offices (DISAs), and 
public health offices (DESAs) are to be incorporated as active collaborators, and, in some 
cases, may receive limited support under the EH Activity in order to better participate. At 
the national level, CONAM is the implementation signatory to the SO12 SOAG, and, as 
such, is the initial recipient of USAID funds budgeted for direct support to GOP 
participating agencies. At regional levels, the respective CONAM regional offices and 
CARs (comites ambientales regionales), sponsored by CONAM, are providing backstop 
technical and management assistance to a greater or lesser degree, as described under 
each pilot project summary.
A. Special Projects in Poor Peri-Urban Areas of Metropolitan Lima.
Three pilot projects intended to test and validate technological and organizational 
innovations for addressing selected priority problems in peri-urban areas of Metropolitan 
Lima were competitively selected for sub-grant funding. These projects respond to three 
priority problem areas designated by DIGESA, and endorsed by the USAID/Peru SO12 
management team. Sub-grantees for each pilot project have been competitively selected 
for developing, testing and validating appropriate management models. 
1. Management Model for Supply of Water for Human Consumption by Tank Trucks.
a. Sub-Grant NGO: Fomento de La Vida (FOVIDA).
b. Other Partners/Alliances: Municipal Government of Villa El Salvador ; asentimientos 
humanos (peri-urban settlements) of Victor Chero, Aires de Pachacamac, Max Uhle, and 
Quebrada Horizonte; 
c. Pilot Project Area and Coverage: The four participating peri-urban settlements include 
over 1,000 families. Participation is organized around 18 neighborhood "block leaders" 
elected by participating families.
d. Summary Project Purpose: Study, develop and apply a management model for assuring 
safe water consumption by poor peri-urban families using tank truck services in the 
absence of availability of connection to the metropolitan water supply utility 
(SEDAPAL). The project is to address water quality protection throughout the entire 
8
marketing chain from the supply source, through tank truck distribution services, and 
storage and use by communities and families. Results are to include development and 
application of a workable regulatory framework (for municipal application through 
ordnances), a validated tank truck water supply management model, and a proposal for a 
national program to assure safe water supplies for families and communities dependent 
on tank truck water supply services. 
e. Summary Project Status: The general work plan has been completed and approved. 
The diagnostic of the current situation has been completed. Based on this diagnostic, and 
using an approach that involves continuing participation by local interest groups and 
stakeholders, development of several implementation plans and programs is well under 
way: e.g., management models for assuring safe water distributed by tank trucks, plans to 
monitor water quality, and safe hygiene and EH practices training program plans. 
Training activities already have been initiated. 
f. Funding: Sub-Grant: $70,839; Americas Fund: $70,839; local participation: $7,084.
2. Management Model for Safe Food Handling in "Comedores Populares (communal 
eateries)."
a. Sub-Grant NGO: INCAFAM-Instituto de Investigacion y Capacitacion de la Familia.
b. Other Partners/Alliances: Municipal Government of San Juan de Lurigancho, Central, 
District and Zonal levels of the Asociacion de Comedores Populares, Clubes de Madres 
and other members (socias) of comedores populares selected for application of the model, 
and DIGESA, DISA, PRONAA.
c. Pilot Project Area and Coverage: Four communities in the high zones of San Juan de 
Lurigancho. 40 comedores are selected for application of the model. The communities 
and number () of comedores in each are: 10 de Octubre (14), Jose Carlos Mariategui (5), 
Mariscal Caceres (13), and Cruz de Motupe (8). On average, each of these comedores 
prepares approximately 100 noon meals (raciones) per day.
d. Summary Project Purpose: Study, develop and apply a management model that 
establishes standards and practical guidance for safe and nutritious food preparation and 
consumption through application of self-help measures. Design and validate standards, 
and prepare appropriate didactic and operational materials for a national replication 
program. 
e. Summary of project status: Three diagnostic studies related to food handling and 
hygiene in comedores populares have been completed-cultural, epidemiological, and 
organizational. Operational strategies for carrying out the project have been prepared and 
are being discussed with DIGESA and other participants. The training program plan is 
being developed, and modules for model comedores are being developed.
f. Funding: Sub-Grant: $76,342; Americas Fund: $50,720; Local: $5,214.
9
3. Management Model for a Centralized Treatment System for Solid Wastes Generated 
by Health Care Establishments.
a. Sub-Grant NGO: OACA-Oficina de Asesoria y Consultoria Ambiental.
b. Other Partners/Alliances: Hospital Sergio Enrique Bernales, an NGO to be 
competitively selected to operate the treatment system, other health care providers in the 
Distrito de Comas (as clients of the treatment system).
c. Pilot Area and Coverage: District of Comas with a population estimated at more than 
500,000, and other areas of the so-called "Cono Norte" of metropolitan Lima, most living 
in conditions of poverty or extreme poverty. In the area, there are a number of public 
sector health care providers (in addition to the partner hospital), and several private 
clinics that are potential clients of the treatment system to be established by the project.
d. Summary Project Purpose: Study, develop and apply an integrated management model 
for safe handling of solid waste bio-contaminants generated by health care facilities in 
poor peri-urban areas. The project will result in a validated model for management of 
solid waste bio-contaminants based on a centralized collection, treatment and disposal 
system. It will generate and apply technical norms for each of these steps in the system, 
and includes the design and construction of an appropriate treatment plant. Additionally, 
the project will develop and apply a business and organizational model for operating the 
system.
e. Summary Project Status: The diagnostic and market studies have been completed. The 
market study is under review. Technical design and feasibility studies are essentially 
completed, subject to resolution of a few outstanding issues now being discussed among 
actors and stakeholders. Technical specifications for equipment procurement are 
essentially complete, awaiting final adjustments based on market study and business plan 
approvals.
f. Funding: Sub-Grant: $148,819; Americas Fund: $98,696; local: $19,346.
B. Integrated Local Management Projects.
1. Abatement of Air Pollution in the Cercado of Arequipa. 
a. Sub-Grant NGO: Asociacion Civil LABOR
b. Other Partners/Alliances: ICIGA, Instituto para la Investigacion Pedagogica Yachay 
Wasi
c. Project Area and Coverage: The Central District (Distrito Cercado) of Arequipa 
comprises 2.8 square kilometers, with an estimated population of approximately 93,500. 
Much of the area is dedicated to commerce, but there also are several residential 
neighborhoods that currently are blighted and impoverished. Green areas have steadily 
10
diminished as informal commerce has invaded, and as neighborhoods have decayed and 
been abandoned by nearly all except the extremely impoverished.
d. Summary Project Purpose: Contribute to institutionalization of a participatory model 
for managing environmental health in the city center (cercado) of Arequipa, focused 
especially on air pollution abatement, and based on mobilization of local technical and 
institutional capacities. More specifically, the project is intended to improve urban 
environmental conditions in at least three poor residential neighborhoods in the cercado: 
San Lazaro, Nicolas de Pierola, and Goyeneche y La Salle. 
e. Summary Project Status: Problem diagnosis on a participative basis and dissemination 
of the results is well advanced. A CIIMSA has been established and is actively discussing 
issues related to preparation of a long term redevelopment plan. Neighborhood 
discussions are under way for improved solid waste management, as an integral aspect of 
safe water supplies. Meetings and dialogue are proceeding among CIIMSA members and 
with selected transportation companies about strategies for reducing the impact of vehicle 
emissions on air quality in the city center. Progress is being made in implementing an 
initial program of communal air pollution monitoring. An EH education program in 
schools and among residents has been designed and implementation is being initiated.
f. Funding: Sub-Grant: $316,350; local counterpart: $15,818.
2. Solid Waste Management in Puno.
a. Sub-Grant NGO: CIED-Centro de Investigacion, Educacion y Desarrollo
b. Other Partners/Alliances: Provincial Municipality of Puno, Local Mothers' Clubs, local 
business association, regional DESA, local CIIMSA, Universidad del Altiplano.
c. Project Area and Coverage: The entire provincial solid waste management and disposal 
system will be assisted through information generation and transfer, appropriate training 
and organizational assistance, and assistance in repair and maintenance of related 
equipment. An estimated 200 families in selected poor peri-urban neighborhoods will 
have organized and be effectively operating a solid waste cleanup and management 
program.
d. Summary Project Purpose: The project purpose is to reduce environmental 
contamination by solid wastes. This will be achieved by implementation of an integrated 
plan for solid waste management for Puno, which in turn requires strengthening of local 
capacities to formulate and manage solutions. The PACE-EH local participation model 
will be applied to mobilize citizen support and municipal commitment to achieve the 
purpose, and to apply the model to selected poor neighborhoods.
e. Current Status: The local CIIMSA has been organized and is actively participating in 
preparation of the PIGARS. Local participation has been organized and trained, and 
selected local groups are ready to act when approvals are completed.
11
f. Funding: Sub-Grant: $243,748; local counterpart: $12,187.
3. Safe Water Supply and Sewerage Services in Tarapoto.
a. Sub-Grant NGO: CEPCO
b. Other Partners/Alliances: Project HOPE (in consortium), neighborhood association of 
Vista Hermosa and parts of other bordering neighborhood associations (Las Flores, 
Venecia, La Florida), District Municipality of Banda de Shilcayo; San Martin Municipal 
Water and Sanitation Company (EMAPA San Martin).
c. Project Area and Coverage: Approximately 400 families in and around the poor 
settlement of Vista Hermosa. This settlement is less than 2 years old, and surrounding 
areas are 2-4 years old.
d. Summary Project Purpose: Apply the PACE-EH model to organize and train the local 
population of Vista Hermosa and surrounding areas in appropriate EH and hygiene 
practices; mobilize local participation in a self-help program to provide a safe water 
source and piped distribution system for the area of Vista Hermosa and some surrounding 
areas; provide communal latrines and bath facilities (and related sewage disposal 
facilities), organize, mobilize and institutionalize the local CIIMSA to provide leadership 
in improving EH conditions in the rest of the municipal district and in the province of 
Tarapoto. 
e. Current Status: After a false start with another poor community (that was unable to 
resolve legal problems related to the land occupied), Vista Hermosa is now organized and 
trained in self-help EH opportunities, legal status to install water supply and communal 
sewage is virtually finalized (final registration of titles and related documentation is being 
completed by a notaria publica), CIIMSA has endorsed the project, DIGESA technical 
approval is complete, and formal administrative approval is in process. Construction, 
with self-help community labor, is expected to begin within a month.
f. Funding: Sub-Grant: $235,056; local participation: $11,753. 
4. Provision of Safe Water and Sewerage Utilizing the Condominial Approach in Iquitos.
a. Direct Implementation: CARE/Peru.
b. Other Partners/Alliances: Maynas Provincial Municipality, SEDALORETO, Consorcio 
Loreto, Programa A Trabajar Urbano, and others.
c. Project Area and Coverage: Peri-urban neighborhood of Manuel Cardozo, and 
bordering areas of at least three other neighborhoods: Jessica Inchaustegui, Oscar Ivan, 
and Kuwait. Approximately 1400 poor families will benefit.
12
d. Summary Project Purpose: Through application of the local participation model, 
design, develop and implement a condominial water and sewerage system (an appropriate 
technology system developed by the World Bank WSP Program). This includes involving 
beneficiary communities in planning and implementing construction and installation. It 
also includes environmental health and hygiene education for residents through a local 
participation approach that utilizes voluntary neighborhood promoters (block delegates), 
understanding about how to operate, maintain and manage installations, and application 
and operation of a local EH risk monitoring system.
e. Summary Project Status: Project operating plans has been approved and installation of 
the water distribution system is under way (scheduled for completion in 
August/September). The CIIMSA has been established and is actively taking initiatives in 
supporting and facilitating all aspects of the project. An educational plan has been 
approved and is under way. Key elements for implementation, the neighborhood board, 
block delegates, and voluntary neighborhood EH promoters are organized and active, and 
their education in EH matters is well advanced. Teachers in local schools have been 
trained, and material developed and distributed for initial EH education. Indicators and 
materials for local EH risk monitoring have been validated locally.
f. Funding: MUSA: $218,619; other local and national sources: $624,719.
V. Evaluation Procedure.
This progress evaluation was carried out from April 22, 2003 to May 20, 2003. An 
outside evaluator reviewed relevant documentation and was briefed by the 
USAID/Peru/ENR EH Activity manager and other members of the SO12 management 
team. The outside evaluator, accompanied by the USAID/Peru EH Activity manager 
and/or other members of the USAID/Peru SO12 management team, was briefed on 
progress in meetings with management and technical staff of the CARE/Peru consortium 
institutions, and all pilot project sites were visited (see above descriptions). These site 
visits provided the opportunity to interact with community leaders, staff of the respective 
sub-grant recipient NGO's (and their partners), and with other participating/collaborating 
organizations, including municipal authorities and regional public health staff (of DISA's 
and DESA's) providing assistance and/or support to the respective local pilot project.
Additionally, the outside evaluator had the opportunity to meet briefly with selected 
management and technical staff of DIGESA, and with the CONAM coordinator for the 
EH Activity. Continuing consultations with the USAID/Peru EH Activity manager and 
other SO12 management team members contributed valuable additional information for 
formulation of evaluation findings, conclusions and recommendations. Any errors or 
omissions in this report are the sole responsibility of the outside evaluator.
File: Fplima001/ENR/FMann/Attachment One to MUSA Progress Evaluation Report
ATTACHMENT TWO TO PROGRESS EVALUATION REPORT
______________________
 PROYECTO DE MODELOS URBANOS DE SALUD AMBIENTAL
(MUSA PROJECT)
LIST OF ACRONYMS
__________
USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
LIST OF ACRONYMS
CARE: Signatory to the MUSA Project Cooperative Agreement
CARE/Peru: Lead institution of the consortium implementing the MUSA Project
CARs: Regional environmental committees established by CONAM
CDC: United States Centers for Disease Control
CEPCO: sub-grantee NGO
CIED: Centro de Investigacion, Educacion y Desarrollo (sub-grantee NGO) 
CIIMSA: Local Inter-Institutional Committee for Management of Environmental Health 
CONAM: National Environmental Commission of Peru
CRA: Comparative Risk Assessment for Lima
DESCO: Center for Development Studies and Promotion
DESA: Regional Public Health Office of MINSA
DIGESA: General Directorate of Environmental Health of MINSA
DISA: Regional Environmental Health Office of MINSA 
EH: USAID/Peru Urban Environmental Health and Hygiene Behavior Activity
EHP: USAID centrally funded Environmental Health Program
EMAPA: Public Water and Sewer Company for the Department of San Martin
EMS: Environmental Management Systems approach 
ENR: USAID/Peru Office of Environment and Natural Resources
FOVIDA: Fomento de La Vida (sub-grantee NGO)
GOP: Government of Peru
HOPE: Project HOPE, a US NGO (partner to sub-grantee CEPCO)
ICIGA: Instituto para la Investigacion Pedagogica Yachay Wasi (partner with LABOR)
INCAFAM: Instituto de Investigacion y Capacitacion de la Familia (sub-grantee NGO)
INFORMET: Information and Methodologies for Organizational Development 
(CARE/Peru consortium member)
LABOR: Asociacion Civil LABOR (sub-grantee NGO)
LGTMU: Local Grants Training and Management Unit of MUSA
LOP: life of project
MES: USAID/Peru Mission Environmental Strategy
MINSA: GOP Ministry of Public Health 
MUSA: CARE/Peru Consortium Urban Environmental Health Models Project
NGO: non-governmental organization
OACA: Oficina de Asesoria y Consultoria Ambiental (sub-grantee NGO)
PAAG: MINSA General Directorate of Public Health program administration unit
PACE-EH: Protocol for Assessing Community Excellence in Environmental Health
PAHO-CEPIS: Pan-American Health Organization, regional Center for Sanitary 
Engineering and Environmental Sciences
PIGARS: Plan Integral para la Gestion Ambiental de Residuos Solidos
PMP: Project Monitoring Plan
PRONAA: Programa Nacional de Asistencia Alimentaria
RFA: Request for Application
SEDALORETO: Loreto Municipal Water and Sanitation Company
ii
SEDAPAL: Metropolitan Lima Public Water and Sewer Company
SENREM: Sustainable Environmental & Natural Resources Management Activity. 
SIMOLORSA: local environmental health risks monitoring system
SOAG: Strategic Objective Grant Agreement
SO4: USAID/Peru Environment and Natural Resources Strategic Objective (now SO12) 
SO12: USAID/Peru Environment and Natural Resources Strategic Objective
UCA: Coordination Unit in DIGESA for EH Activity 
UNDP: United Nations Development Program
USAID/Peru: United States Agency for International Development Office in Peru
WSP: World Bank/UNDP Regional Water and Sanitation Program
ATTACHMENT THREE TO PROGRESS EVALUATION REPORT
PROYECTO DE MODELOS URBANOS DE SALUD AMBIENTAL
USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
(MUSA PROJECT)
__________
______________________
ii
PARTIAL LIST OF CONTACTS BY POSITION AND ORGANIZATION*
Acevedo, Lic. Ana Maria: Directora Ejecutiva Programa de Salud para el Desarrollo 
Local, FOVIDA
Alarcon, Edilberto, USAID/Peru/ENR, EH Activity Manager 
Albinagorta J., Jorge A.: Coordinador, UCA/EH, DIGESA
Alegre Chang, Marcos: Director, OACA
Almuelle Angeles, Maria del Carmen: Mg. Planeamiento y Gestion Ambiental, ADIS
Aranibar Cerpa, Jenny: Directors Maestra de Salud Publica, Docente UNA
Ayala Camavilca, Rogelio: Jefe Policia de Turismo
Baffigo de Pinillos, Dra. Virginia: National Coordinator of the MUSA Project, 
CARE/Peru
Berolatti de la Cuba, Carlos: Jefe del Proyecto de Conservacion de Biodiversidad en 
Comunidades Campesinas, CIED
Campana Segovia, Pilar, Sociologo, MUSA sub-grant project, FOVIDA
Carbajal Falcon, Freddy: MUSA sub-grant project, FOVIDA
Carron Palomino, Ing. Marco, SEDAPAL
Castillo, Oscar: Specialist in community and institutional development, World 
Bank/UNDP Regional Water and Sanitary Program (WSP)
Chavez Pais, Ing. Luis L.: Director General, DIGESA de MINSA
Chirino Gomez, Rolando: MUSA sub-grant project, FOVIDA
Cordous Luque, Dr. Renatto: Jefe de Sanidad, Municipalidad de Villa El Salvador
Cuadros, Carlos, MUSA, CARE/Peru
Cuentas A., Martha: Directora Ejecutiva, FOVIDA
Del Aguila Rodriguez, Luis: Director de Programas y Proyectos, INFORMET
del Aguila, Luis: capacitacion, INFORMET
Dyer Estrella, Jaime: Gerente General, OACA
Espinoza, Leonor, Director de proyecto, INCAFAM
Estrella, Carmen Carlos: MUSA sub-grant project, FOVIDA
Gil Ruiz, Juan: Executive Secretary, The Americas Fund in Peru
Goyzueta Camacho, Gilmar: Docente Universidad Nacional del Altiplano (UNA), Puno
Guzman, Edwin: Director, Asociacion Civica LABOR
Haak, Roelfien, Presidente, FOVIDA
Hidalgo, Jorge: presidente, Comite Local de Administracion de Salud (CLAS), Tarapoto
Injanto Uchuya, Julio: Director, Direccion de Desarrollo Humano, Municipalidad de 
Villa El Salvador
La Rosa, Miguel, MUSA Project technical staff, CARE/Peru
Larico Fernandez, Felipe: Jefe Division de Saneamiento Ambiental, Puno
Llanos Fernandez, Lucila: Profesora de colegio, Puno
Lopez Gonzalez, Jorwerd: Asociacion de Desarrollo Integral Sostenible del Barrio de San 
Lorenzo (ADIS)
Lopez, Anita; Ing. Sanitaria, Dpto. De Produccion, EMAPA, Tarapoto
Lopez, Jose Luis: presidente, LABOR
Maman, Paulino: Villa El Salvador
Mamani Damian, Manuela: Presidenta Club de Madres Chejona, Puno
Matute Pinedo, Jaime: Secretario Ejecutivo Regional Loreto-San Martin, CONAM
iii
Monasi Franco, Dr. Jorge: Alcalde, Municipalidad Distrital San Juan Bautista, Loreto
Moreno Terrazas, Edmundo: Docente UNA, Puno
Noriega D., Jorge: principal investigator, DESCO
Noriega, Jorge: DESCO 
Nunez Prado, Candida: Presidenta Club de Madres La Pampilla, Puno
Olero, Freddy” Economista, LABOR
Palomino, Luis: promoter PELPEMA, Villa El Salvador
Pantoja Mori, Juan Martin: Presidente del presupuesto participativo, Villa El Salvador
Pilares, Jorge: Medico, Arequipa regional office, MINSA
Rios, Ines: MUSA sub-grantee project, LABOR
Rodriguez B., Hugo Alfredo: Director-Puno, CIED
Rottler Hassinger, Norma: Directora Liderazgo Ciudadania, MUSA sub-grant project, 
FOVIDA
Ruiz Rios, Albina: Directora del Proyecto Manejo Sostenible de Residuos Solidos en 
Carhuaz, Sociedad Peruana de Derecho Ambiental (SPDA)
Salas Aguilar, Rosa Virginia: Director of STEM-SENREM in CONAM
Sandoval Alvarado, Leandro: Asesor en Residuos Solidos Urbanos dePAHO-CEPIS
Suasaca Barrera, Julia: member, Club de Madres Senor de Huanca, Puno
Talavera Ampuero, Eduardo: Secretario Ejecutivo Regional Arequipa-Moquegua-Tacna, 
CONAM
Tallada, Ana: Directora Ejecutiva, INCAFAM
Vargas Vargas, Edgar, Ingeniero Sanitario, INCAFAM
Vargas, Edgar: Ingeniero Sanitario de TECNHIDRAM
Vasquez, Francisco: Gerente General, EMAPA, Tarapoto
Vigil Barreda, Lic. Saul: nutricionista, INCAFAM
Villalta Flores, Luis: Director, Direccion Ejecutiva de Salud Ambiental, Municipalidad 
Provincial de Puno
Vivar, Aldo: consultor in infection control, PRISMA
Zaira de Ticona, Ayde: Secretaria Club de Madres 28 de Julio, Puno
Zea Usca, Jaime A.: Alcalde, Municipalidad Villa El Salvador
Zevallos Pacheco, Jose E.: Gerente Administrativo, FOVIDA
iv
ATTACHMENT FOUR TO PROGRESS EVALUATION REPORT
______________________
 PROYECTO DE MODELOS URBANOS DE SALUD AMBIENTAL
(MUSA PROJECT)
__________
USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
v
PARTIAL LIST OF REFERENCE DOCUMENTS
CARE, Technical Proposal and annexes for MUSA
CEPCO, Proyecto modelo de gestion de agua segura y saneamiento en zonas marginales
CIED, Proyecto de Manejo Integral de RRSS en la Ciudad de Puno
Fondo de las Americas/CARE, Plan Operativo de Co-financiamiento INCAFAM￾FOVIDA-OACA
FOVIDA, Modelo de Gestionpara el Astecimiento de Agua de Consumo Humano 
Mediante Camiones Cisterna en Zonas Marginales
INCAFAM, Modelo de Gestion para la Obtencion de Alimentos Seguros en Comedores 
Populares
LABOR, Gestion de Salud Ambiental y Descontaminacion Atmosferica en la Ciudad de 
Arequipa
MUSA, Bases de Concurso de seleccion the Sub-donantes
MUSA, El Modelo PACE-EH
MUSA, Informes Trimestrales (Numeros 1, 2, 3, 4, 5 and 6).
MUSA, Plan Operativo Anual (POA) Set. 2002 - Set. 2003
MUSA, Plan de Monitero y Evaluacion
MUSA, Plan General de Implementacion Set. 2001-Set. 2004
MUSA, POA 2002-2003
MUSA, Proyecto Sistema Condominial de Agua Potable en Cardozo
MUSA, Proyecto Sistema Condominial de Alcantarillado en Cardozo
Narciso Chavez, Juan, Elementos para el Diagnostico de la Contaminacion del Aire de 
una Localidad.
OACA, Modelo de Gestion para Residuos Solidos de Establecimientos de Atencion de 
Salud
USAID/Peru, EH Activity Paper
USAID/Peru, RFA No. 527-01-A-004
vi
ATTACHMENT FIVE TO PROGRESS EVALUATION REPORT
______________________
 PROYECTO DE MODELOS URBANOS DE SALUD AMBIENTAL
(MUSA PROJECT)
__________
USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
vii
SCHEDULE OF EVALUATION ACTIVITIES
April 21: Travel from US to Peru
April 22-24: General Briefing by USAID/Peru/ENR, and CARE/Peru Consortium; 
documents review
April 25: Briefings by CEPIS, Americas Fund; documents review
April 28: Meetings with FOVIDA; sub-grant project site visit to Villa El Salvador
April 29: Meetings with INCAFAM; sub-grant project site visit to San Juan de 
Lurigancho
April 30: Meetings with OACA; sub-grant project site visit to Hospital Sergio Bernales, 
Collique
May 1-2: Discussions with USAID/Peru/ENR; documents review
May 5-7: Sub-grant project site visits to Arequipa and Puno
May 8-9: Sub-grant project site visit to Tarapoto
May12-13: Sub-grant project site visit to Iquitos
May 14-16: Write report; present draft report to USAID/Peru/ENR for comments
May 19-20: Incorporate ENR comments and finalize report; exit briefings with 
USAID/Peru/ENR and Mission Director
 May 21: Leave Peru for US
viii
ATTACHMENT SIX TO PROGRESS EVALUATION REPORT
______________________
 PROYECTO DE MODELOS URBANOS DE SALUD AMBIENTAL
(MUSA PROJECT)
USAID/Peru Urban Environmental Health and Hygiene Behavior (EH) Activity.
ix
MUSA BUDGET AND EXPENDITURES BY PURPOSE
Rubros Presupuesto % 
Presupuesto
Ejecutado a 
02/03
% de 
Ejecucion
MUSA/LGTMU
-Capacitacion
-Gestion Tecnica
 Monitoreo
 Advocacy
 Personal*
 --Componente Administrativo
 --Componente Tecnico
 Asistencia Tecnica
 Bienes y Servicios
-Auditoria financiera
-NICRA y Gastos Generales Administrativos
SUB-PROYECTOS
-Iquitos
-Proyectos de sub-donacion
-SIMOLORSA 
1,123,527.00
107,124.00
601,576.00
54,294.00
21,600.00
478,651.00
(124,449.00)
(354,202.00)
25,000.00
22,031.00
70,000.00
344,827.00
1,406,473.00
218,619.00
1,091,154.00
96,700.00
44.41
4.23
23.78
2.15
0.85
18.92
4.92
14.00
0.99
0.87
2.77
13.63
55.59
8.64
43.13
3.82
428,074
47,947
269,802
10,170
12,445
238,187
61,929
176,258
7,129
15,195
0
119,325
158,061
59,325
82,730
16,006
38.1
44.8
43.4
18.7
57.6
49.8
49.8
49.8
28.5
69.0
0.0
34.6
11.2
27.1
7.6
16.6
Total Aporte USAID 2,530,000.00 100.00 586,135 23.2
Cost-Sharing 843,333.00 227,248 27.0
Gran Totales (USAID y CARE) 3,373.333.00 835,698 24.8
* % de Dedicacion % Tecnico % Administrativo
A tiempo Completo 
 Coordinadora 80 20
 Responsable Capacitacion, edu y social 100
 Responsable Salud Ambiental 100
 Administrador 25 75
 Asistente Administrativo 100
 A Tiempo Parcial
 Gerente de Salud (8%) 100
 Asesor Ambiental (5%) 100
 Asesor agua y saneamiento (5%) 100
 Asesor en monitoreo y evaluacion (5%) 100
x
SUB-PROJECT FUNDING SOURCES AND AMOUNTS
SUB-PROYECTO FONDAM USAID/CARE OTROS TOTAL
Especializados
 -Camiones Cisterna (Villa El Salvador)
 -Comedores Populares (S. J. de Lurigancho)
 -RR. SS. de Centros de Salud (Collique)
sub-total
Porcentaje
70,839
50,720
98,696
220,255
(40.2%)
70,839
76,342
148,819
296,000
(54.0%)
7,084
5,214
19,346
31,644
(5.8%)
148,762
132,276
266,861
547,899
(100%)
PACE-EH
 -CEPCO (Tarapoto)
 -CIED (Puno)
 -LABOR (Arequipa)
sub-total
Porcentaje
0
0
0
0
(0%)
235,056
243,748
316,350
795,154
((95.2%)
11,753
12,187
15,818
39,758
(4.8%)
246,809
255,935
332,168
834,912
(100%)
CARE/Peru Implementacion Directa
 -Iquitos
Porcentaje
0
(0%)
218,619
(25.9%)
624,719
(74.1%)
843,338
(100%)
GRAN TOTAL
-MONTO
-%
220,255
(9.9%)
1,309,773
(58.8%)
696,121
(31.3%)
2,226,149
(100%)
CO-FINANCIAMIENTO
- FONDAM 220,255 (19.5%)
- OTROS 696,120 (61.5%)
- ADMIN. LOCAL (CARE/Peru) 215,000 (19.0%)
 
 TOTAL 1, 131,375 (100%)
(Como % de la Inversion Total en Sub-Proyectos) 46.4%