Rain and harsh winter cold, along with the refusal of many southern Italians to accept government urgings to evacuate their shattered home towns, are hindering the mammoth relief effort now under way here.

But five weeks after the country's most deadly quake in 65 years, the major problem appears to be Italy's endemic lack of government efficiency and coordination. These characteristics are aggravated by a natural disaster of immense proportions and further exacerbated in the less developed south, which, unlike other parts of Italy, has few institutions to rely on other than the family.

Relief officials said that more than half of the 300,000 people left homeless by the earthquake of Nov. 23 are still without adequate housing. Health officials in Naples said hundreds of infants and old people in tent cities throughout the quake-stricken area are suffering from bronchitis, pneumonia and other respiratory ailments. One official called the situation "extremely grave.

White the situation appeared to vary greatly among the 485 towns and villages hit, the major impression after a two-day visit to the stricken area was one of chaos, disorganization and confusion.

There appeared to be much confusion over statistics on the actual population of the afflicted area, the amount of damage and the precise number of people who have left the area of even the country with relatives, who often arrived on the scene before the representatives of the state.

Partly because many city halls were destroyed or because emigration figures were not always accurately recorded, and partly because in some towns many of the dead are still buried, there is even confusion about the final death toll. A slow increase in the count -- now over 3,000 -- has convinced many Italians that the final total could be substantially higher, and has created suspicion that the government could be trying to minimize the tragedy.

In some areas, relief efforts appeared submerged in chaos. "When are they going to send animal feed?" an unshaven man with staring eyes in a wool cap yelled at the Christian Democratic mayor of Calabritto a town of 3,000 where the earthquake killed at least 150 people and destroyed almost of the houses, the sewers, and electricity network. The mayor, a lawyer named Antonio Zecca, said that, although the town had enough food, it needed at least 100 more camper trailers to house people still sleeping in cars, and that sufficient heavy earth-moving equipment still had not arrived.

Because the town had no storage space, piles of soggy clothing lay in heaps along the road and were being taken away to be burned. Just outside the shattered old town center, stacks of coffins -- dark brown for adults, white for children -- and crates of potatoes lay uncovered in the pouring rain. w

A few miles away in Teora, where red-bereted soldiers from a West German engineers corps worked in ankle-deep mud alongise brown-suited Italian fireman, the relief effort seemed better organized. Neat rows of Army tents were lined up, and a helicopter landing pad had been constructed nearby. "Now it's going well," said a volunteer from an unscathed village about 25 miles away. But asked why the digging was going so slowly, a German corporal answered, "Italian Army too slow," and added that no one was really giving orders or seemed to be in charge.

One problem is the vastness of the dimensions involved: the afflicted area is over 10,000 square miles and inhabited by 3.5 million people. The worst-hit area, the so-called Triangle of Death in Irpinia, is a mountainous area with mostly narrow, secondary roads.

The size of the problem is compounded by the fact that the structure of southern Italian society differs considerably from that in the more community-oriented north. In the south the municipalities and the mayors exist primarily as expressions of political patronage.

But efficiency has never been a strong point of public administration in a country where the perennially ruling Christian Democrats have traditionally prized party standing and loyalty far above technical and loyalty far above technical and managerial expertise.

This tendency is more pronounced in the less-industrialized south, where an elite steeped in literary, academic, and rhetorical traditions for outnumbers those equipped for the problem-solving needed in a modern nation.

"More than ever before, the earthquake has revealed the failures of the Italian state," said Giovanni Russo, a leading commentator on southern questions.

The earthquake has also refocused attention on the government's longstanding neglect of the south. "The state moves quicker for Florence than it does for Sicily," said Russo bitterly, pointing out that 35,000 victims of the 1968 earthquake in Sicily are still living in corrugated tin huts.