This study is a description and analysis of the Tufts-Delta Health Service Project in Mound Bayou, Mississippi over a six-year period from 1967 to 1972. The purpose of the study was to identify and describe the factors which contributed to the development and decline of this Project as an experimental model for delivery of health services to a rural, poverty population. Located in an all-black community, the Project established the first rural health center in the United States following legislative action to declare War on Poverty The research design followed the case study method. Data sources included historical literature, government and organizational documents, interviews, and participant observation over a two-year period. The primary focus of the study was on information obtained from former professional and administrative personnel who had been employed with the Project. Study participants supplied information in response to an open-ended, pre-tested questionnaire. The questionnaire was designed to elicit both negative and positive factors which contributed to the Projects' operation and subsequent decline. The study was presented from a historical perspective within the theoretical framework of socioeconomic factors relevant to Black Americans in American society The findings indicated that the Tufts-Delta Health Service Project had both negative and positive factors which influenced the Projects' development, organization, operation, and decline. Although many of the problems encountered by the Project had their roots in the historical socioeconomic environment, many other problems evolved as a result of the Projects' orientation and methods of operation. Most of the negative factors expressed by study respondents related to inadequate management and administration of the Project. Based on the findings of the study, recommendations were made for improvements in health service delivery. Recommended improvements included changes in administrative structure, personnel management, communication and cooperative relationships, consumer involvement, and planning and evaluation of health needs and resources. The study findings indicated that current and future administrators have a crucial responsibility in the management of health care services The Tufts-Delta Health Service Project presented an opportunity for development of new methods in health care delivery. Flexible and innovative in its approach to meeting broad health needs, the Project was perceived as an intervention for bringing about social change through delivery of comprehensive health services. The significance of this study is in its attempts to define a problem for which there is a current lack of knowledge and understanding. As the first general and complete description of a health care project which declined, in spite of adequate funding initially, this study has value and importance for its ability to provide focus and clues for future needed research in health care services administration and financing. The study also offers an opportunity to learn from past mistakes to prevent future costly errors in the development and management of health care services delivery
