Final report by Africare on a project (7/93-9/96) to reduce water-borne and other diarrheal diseases in selected peri-urban and rural populations in Beira and Chibabava District, Sofala Province, Mozambique. In 5/94, the WASH project, which had spearheaded the original project design, redirected the project's strategy, reducing certain "quantifiable outputs" (e.g., water points) and increasing public health education efforts. Due to the lack of the expected participation from government and volunteer agencies, Africare identified other interested and capable organizations to work with, including the government's low-cost latrine program, the Industrial and Commercial Institute of Beira (IICB), and the Beira City Council. The level of community organization that was ultimately promoted by the project's information, education, and communication (IEC) component was significantly larger than expected (due in part to the reduced participation of other agencies). During the first half of the project, more than 300 residents of Beira began to support public health promotion activities and conduct nonformal training with their neighbors under supervision of project health trainers. While the technical quality of the water points that were developed by Africare was extremely high, water quality within the wells in particular was often not much improved, due to public defecation and improper disposal of garbage. It is probable that the water table in many parts of the city remains contaminated throughout the year. The solution to this problem lies with public health education. Development of a Health Information System (HIS) was complicated and time-consuming. Despite some methodological problems, however, there is evidence that project activities did lead to behavioral change within the resident population, indicating a clear and important contribution to the state of health, water, and sanitation in both project sites. In some ways, this project, specifically the work in and around Beira city, was a new activity for Africare. It also represents a trend with which Africare, as an international PVO dedicated to improving living conditions in rural Africa, has had to contend: the increase in development needs and opportunities within peri-urban (or peri-rural) environments. The inability of governmental agencies to provide the necessary basic services was the context for this project. A contributing factor was the nature of the residents themselves -- Beira's residents are a heterogeneous mix of rural and urban people, including a large number of refugees, demobilized soldiers, and other dislocated persons from diverse ethnic groups in the central and northern provinces of the country. Several local organizations expressed interest in collaborating with the project, including exploring the possibility of continuing activities beyond 1996. The IICB has developed its own funding proposal to continue water and IEC activities. Africare's IEC staff worked with KULIMA, a Mozambican NGO, during the project's final 3 months to train its staff in the educational methodology that Africare uses and to introduce them to the nine different social clubs/community groups created during the final year of the project. Africare staff focused on the theme of "self-reliance" during its final activities with the nine social clubs and continually requested contributions (especially material) from residents during the project's latter half. The potential for long-term support from agencies such as IICB or KULIMA would be strongly enhanced if community groups were to take on some of the responsibility to improve and maintain their neighborhoods.