Many COSAs stopped operating, and the BCZ and IPS structures weakened.
The number of visits and the geographical distances the monitors need to cover differ considerably IRC has gone furthest with its health monitors: they visit health facilities at least once a week, and they visit the HCs with the BCZ supervisors, at least once a month.
Health monitors and BCZ staff generally examine the orders for medicine together to ensure accuracy All organizations have conditions that HCs need to fulfill before delivery of supplies.
(16) IRC medical personnel worked with the COSA and BCZ of each HC to determine standard criteria by which an individual or a family can by classified as indigent.
Ultimately, this balance depends on the managerial and professional skills of the BCZ and other health service staff.
If IRC staff notices this they can send a warning letter and talk to the BCZ. The BCZ can also ask staff for an explanation.
In zones where the BCZs already had prior working experience with international organizations, they tended to be more demanding, partly because they were more set in their ways and expectations, and partly because they knew better how to play the international aid system.
Throughout 2002, MERLIN established an innovative revocable contract approach with the BCZs as well as with the different health facilities in its zones.
In addition to the free or low-cost supply of medicine, measures to increase revenues include direct subsidies--most BCZs receive office materials, gasoline and a monthly sum of cash to continue operating--and funding to treat the indigent.