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Paraguay
FY 2001 Program Description and Activity Data Sheets
>> Regional Overview >> Paraguay Overview FY 2001 Program
USAID/Paraguay's experience with its current strategy has been successful. The Mission needs to continue to strengthen an active civil society to put pressure on the current political system to change and become responsive, and at the same time assist local governments in meeting demands for basic public service delivery. The most progressive and positive system changes are taking place at the local and regional level and deserve continued support. The Mission will also manage for results aimed at introducing major policy changes and instituting good governance practices that are receptive to civil society's needs.
By the end of its current strategy in FY 2000, the Mission expects to: 1) finalize the reform of the electoral code; 2) strengthen important segments of civil society through NGO advocacy; 3) pull political parties fully into the democratic process; 4) introduce municipal alternative dispute resolution centers which will enhance access to justice; 5) continue promoting the decentralization process and increase citizen involvement in decisions affecting their communities; 6) begin implementation of the new Penal Code and the Criminal Procedures Code; 7) expand the decentralized provision of health services that are based on voluntary family planning; and 8) protect important parks and reserves while developing economic alternatives to deforestation.
The Mission will build upon these successful elements of its current programming during the new strategy period, FY 2001 - FY 2005, while at the same time introducing some new approaches. The Mission's three Strategic Objectives will place a greater focus on civil-society organizations and their fundamental role in democratic governance. Efforts with local governments will be expanded and deepened with an emphasis on their role as service providers, especially to marginalized groups. Anti-corruption initiatives will be introduced in the context of each program area. USAID/Paraguay will focus on geographical areas identified by a criteria mix of population density, poverty levels, and political representation. The Mission will concentrate on limited, demonstration projects that larger donors or the GOP itself can replicate. These efforts will assist a majority of the population identified to be living in poverty conditions.
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ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Improved Responsiveness and Accountability of Key Democratic Institutions, 526-001
PLANNED FY 2000 OBLIGATION AND ACCOUNT: $2,700,000 (DA), $1,000,000 (ESF)
PROPOSED FY 2001 OBLIGATION AND ACCOUNT:none
STATUS: Continuing
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2000Summary: The transition to a democratic society in Paraguay is still fragile and uncertain. Since emerging from a 34-year dictatorship in 1989, Paraguayan society has been expecting to reap the economic and social benefits of democracy. After ten years, many Paraguayans are unsure if democracy will deliver the promised better life and some are yearning for an authoritarian government to return. The purpose of this objective is to strengthen Paraguay's nascent democracy by improving government responsiveness and accountability through the creation of an effective judiciary, an independent functioning electoral system, transparent local governments with decentralized services based on wide citizen participation and an active, responsible civil society.
Key Results: Four key intermediate results are being achieved under this Strategic Objective. 1) Free and fair elections with wide national participation and acceptance are instilling confidence in the basic democratic process. 2) Participatory and better functioning local governments are shaping an increasingly decentralized decision-making and service delivery process. 3) A more responsive, accessible judiciary is starting to improve access to justice, a key to people's belief in a democratic society, as well as a necessary ingredient to encourage economic development. And 4) a frank and open civil-military dialogue is helping the military to understand its new role in a democracy and to ensure appropriate civilian oversight over the military.
Performance and Prospects: Performance during the current Strategic Plan has been better than expected. Technical assistance was provided to the Election Tribunal to create a new voter registry, inform voters of electoral procedures, and successfully conduct the 1996 and 1998 elections with an impressive nationwide turnout of 81%. The democratic values survey taken after the 1998 elections revealed that 75% of those surveyed believed that the elections were clean, compared to only 45% in regard to the 1993 elections.
Local governments are receiving training in administration, budgeting, and transparent financial management, and are part of a USAID-sponsored policy dialogue on decentralization. Citizen groups are playing a greater role in defining local priorities and are participating in community-wide public hearings.
Support has also been provided to enact a new Penal Code, which went into effect in 1998, and a Criminal Procedures Code, which went into effect in 1999. These are two of the four major legal reforms targeted by USAID that have modernized the judicial sector by moving from an inquisitorial, written system to an accusatorial, and oral process.
The civil-military dialogue support by the Mission has helped form new consensus between the civilian and military leadership to address and define national security threats and to develop a new role for the military.
Possible Adjustments to Plans: In September 1999, the Mission received approval of its new Strategic Plan that will begin in FY 2001.
Other Donor Programs: USAID has taken the lead in encouraging the donor community to support democracy, especially with the Inter-American Development Bank (IDB). Using USAID-initiated studies, the IDB has designed approximately $72 million in complementary projects to help modernize the State, to strengthen the judicial branch ($8.4 million), and provide assistance to the congress estimated at ($500,000). The IDB is also executing a $18 million municipal strengthening project aimed mainly at designing new urban cadasters. The World Bank has a pending $20 million infrastructure loan to the Municipality of Asuncion. The Organization of American States (OAS) has worked closely with USAID in election assistance and has spent approximately $800,000 since 1996 to support the electoral process. The German Technical Cooperation Agency (GTZ) is implementing a penal reform activity ($1.7 million) and a modernization of the Civil Registry ($4 million). Taiwan is lending $20 million to construct a new building for the Congress. And, the European Union has judicial, legislative, and state reform projects ($3 million).
Principal Contractors, Grantees or Agencies: USAID implements activities through several U.S. and local organizations. U.S. principal contractors and grantees are the International Foundation for Electoral Systems (IFES), Development Alternatives Inc. (DAI), and the National Center for Courts (NCSC). Local NGOs and grantees include the Information and Resources Center for Development (CIRD), the Paraguayan Center for Economic Liberty and Social Justice (CEPPRO), and Alter Vida.
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)% of population that considers
the elections clean.45% 75% Number of target sub-national
governments with joint community
project implemented per year.2 14 14 17 Number of key legal reforms
enacted by Congress0 2 3 4
U.S. Finance Table (Microsoft Excel file)
ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Improved Management of an Expanded Protected Areas System, 526-002
PLANNED FY 2000 OBLIGATION AND ACCOUNT: $525,000
PROPOSED FY 2001 OBLIGATION AND ACCOUNT: none
STATUS: Continuing
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2000Summary: USAID contributes to the sustainable development of Paraguay by promoting environmentally sound practices of natural resources management. A significant percentage of the land in the country is owned by large private landowners who use the land for unsustainable agriculture and livestock practices.
USAID is engaging landowners to join conservation initiatives and is providing examples of sustainable economic alternatives for land use. Additionally, USAID is working closely with the government agency responsible for the management and preservation of protected areas by strengthening their institutional capacity and promoting the joint implementation of programs with local NGOs. The purpose of this special objective (SpO) is to improve both public and private management of Paraguay's protected areas.
Key Results: Under this Special Objective, new reserve areas with sustainable management plans have been developed by two local NGOs. The local capacity to manage and understand the importance of protected areas has been considerably enhanced. And economic alternatives to deforestation have been developed.
Performance and Prospects: Performance over the past year has been as expected, although Paraguay, with one of the highest rates of deforestation in the world, continues to lose 10% of its remaining original forest cover every year, threatening the future of unique regional ecosystems. Because environmental problems aggravate poverty and complicate the transition to democracy, it is imperative that Paraguay develop and implement sustainable land use models and preserve the last remnants of these important ecosystems.
Most Paraguayan NGOs have limited technical capacity and financial self-sufficiency. They also lack the political weight to effectively influence how conservation of these key ecoregions will be implemented. Nevertheless, NGOs with interest in these matters do exist. Some are regionally based, while others are dedicated to particular elements of the environment such as environmental law or compatible economic development. In order to fully assume key roles in regional environmental policies, these NGOs require technical training in both internal management and lobbying techniques. To better coordinate with international efforts, they also require improved ties to international NGOs.
Paraguay placed an additional 211,000 hectares under public protection in 1998 based on the USAID-sponsored plan for a national protected areas system. The country's largest national park has been incorporated into USAID's Parks-in-Peril program, which includes an innovative public/private system for park management. This is the GOP's first experience in managing a park with the private sector.
Environmental education remains a challenge and programs are currently being conducted in three key reserve areas. These have demonstrated a measurable positive impact in the reserves and in their buffer zones. Ten viable economic alternatives to traditional agricultural and livestock grazing have been implemented to demonstrate that deforestation in not the only way to earn profits from forested land. Some examples are: reforestation, agriculture under forest cover, sustainable forestry and eco-tourism. With these activities, landowners are engaged in profitable and environmentally appropriate initiatives.
Possible Adjustments to Plans: New programming directions are reflected in the 2001 - 2005 recently approved Strategic Plan. Ecoregional conservation initiatives involving neighboring countries will be promoted.
Other Donor Programs: Other donors continue to be highly involved, in close coordination with USAID, in the conservation of natural resources activities in Paraguay. All donors are working directly with the GOP and in most cases also with local NGOs. The Global Environmental Facility (GEF) is involved in the protection of ecosystems of regional and global importance in Paraguay through a $9 million project. The Japanese International Cooperation Agency is trying to diminish the severe deforestation problem that Paraguay faces with a $7 million forestation project. The German Technical Cooperation Agency is implementing a $3.8 million effort to elaborate a National Action Plan for the protection of natural resources. The European Union is supporting a $18 million Sustainable Development Project for the western region of the country.
Principal Contractors, Grantees, or Agencies: USAID implements activities through The Nature Conservancy (TNC), World Wildlife Foundation (WWF), and two local NGOs, the Moises Bertoni Foundation and the Desdel Chaco Foundation.
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)Number of models of biodiversity
conservation and sustainable use of
natural resources implemented.2 4 5 6 Number of communities engaged
in education and sustainable
development activities.1 4 7 10 Number of economic alternatives
implemented on reserves.6 21 25 30
U.S. Finance Table (Microsoft Excel file)
ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Increased Use of Voluntary Family Planning Services, 526-003
PLANNED FY 2000 OBLIGATION AND ACCOUNT: $2,000,000 (DA)
PROPOSED FY 2001 OBLIGATION AND ACCOUNT: none
STATUS: Continuing
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2000Summary: In 1994, the Government of Paraguay (GOP) made reproductive health and family planning a priority. The Ministry of Health's reproductive health plan endorses reproductive health activities and establishes a variety of goals aimed at fighting the country's very high maternal mortality rate and estimated annual population growth rate (2.6%). The country is now struggling with major reforms in health, education, and family planning services.
The purpose of this special objective (SpO) is to increase current contraceptive prevalence by expanding access and use of voluntary family planning services that reduce maternal mortality and unwanted pregnancies, especially targeting poor women, rural populations and other marginalized groups.
Key Results: Three intermediate results were concluded to be necessary to achieve this SpO: (1) Expanding access to reproductive health services by offering these services through existing public and private facilities which do not currently provide them, rather than establishing new facilities; (2) Improving the quality of reproductive health and family planning services by establishing a range of modern family planning methods by providers with adequate technical and managerial skills; and (3) Having advanced towards the sustainability of family planning services.
Performance and Prospects: Performance over the past year has been better than expected. A national reproductive health survey has demonstrated that contraceptive prevalence for women between the ages of 15 and 49 using modern methods has gone from 35% in 1990 to 41% in 1996. This upward trend is expected to continue and reach the target of 50% prevalence by the end of FY 2000. Couple-years of protection is expanding as a result of contraceptives supplied by the Ministry of Health and the Paraguayan Center for Population Studies (CEPEP), the primary local NGO supporting family planning services. Activities to assist the private sector organize cost-effective services are being carried out through local NGOs and U.S. cooperating agencies. USAID/Paraguay's support for expanded access to family planning services includes the expansion of community-based and alternative distribution systems, including an innovative contraception social marketing program, to reach underserved rural and marginal urban areas. In addition, program efficiency and sustainability are addressed through training and technical assistance in contraceptive logistics management, specialized clinical training, financial and program management, and closer coordination between the public and private sector.
USAID has continued introducing the concept of model quality service delivery in certain regions which more directly addresses specific community needs. This model includes a basic package of selected family planning services for the community and establishes minimum service delivery conditions which assure quality family planning. The number of quality service delivery points has been expanding quite rapidly.
Activities to assist the private sector organize cost-effective services are being carried out through local NGOs and U.S. cooperating agencies. USAID's support for expanded access to family planning services includes the expansion of community-based and alternative distribution systems, including an innovative contraception social marketing program, to reach underserved rural and marginal urban areas. In addition, program efficiency and sustainability are addressed through training and technical assistance in contraceptive logistics management, specialized clinical training, financial and program management, and closer coordination between the public and private sector.
Possible Adjustments to Plans: The Mission's new Strategic Plan was approved in September 1999.
Other Donor Programs: USAID/Paraguay is assuming a leadership role in donor coordination and is leveraging additional resources toward key reproductive health results and is developing new approaches that can be followed by other partners. The World Bank has budgeted $22 million to decrease maternal and infant mortality in six departments in rural areas of Paraguay through improved hospital facilities and equipment, mobile health clinics, procurement of medicine and supplies, human resources training, and other activities with community outreach. The Inter-American Development Bank (IDB) is planning a similar $38 million loan to provide a parallel range of services in five additional rural departments. USAID will carry out demonstration projects that both of these banks can replicate on a larger scale.
The Pan-American Health Organization (PAHO) in Paraguay is working in health sector reform; the institutional development of the MOH; epidemiological surveillance of infectious diseases; and, health promotion and prevention in maternal, child and mental health. PAHO also provides technical cooperation to the MOH for USAID/ LAC Bureau regional health initiatives. The Mission collaborates closely with PAHO on policy development.
The United Nations Fund for Population Activities (UNFPA) is a key partner in the strategic plan. Success in attaining family planning goals is facilitated by UNFPA's assurance of continued provision of contraceptive materials through 2002 and possibly beyond. PAHO and the United Nations Children's Fund (UNICEF) also provide technical assistance to primary care programs in family planning and reproductive health. The International Planned Parenthood Federation (IPPF) provides funding to its local affiliate, for both administrative and program costs and the German Technical Cooperation Agency (GTZ) provides support for a targeted adolescent reproductive health program.
The Japanese International Cooperation Agency (JICA) has been disbursing approximately $1.5 million per year to develop a decentralized health management model in the Department of Caazapa and is coordinating with USAID and the GOP under the U.S.-Japan Common Agenda to realize recommendations in reproductive health, such as training midwives and conducting information, education and communication campaigns.
Principal Contractors, Grantees or Agencies: USAID implements the program through the following U.S.-based organizations: Population Services International (PSI), Access to Voluntary and Safe Contraception (AVSC), Johns Hopkins University (PCS-JHU), the University of North Carolina, and the Centers for Disease Control (CDC). Local organizations funded by the Mission are the Paraguayan Center for Population Studies (CEPEP), the Information and Resources Center for Development (CIRD), and Promotion for Health Improvement (PROMESA).
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)Contraceptive prevalence for
women 15-49 using modern
methods41% 49% 50% Couple years of contraceptive
protection (Ministry of Health,
PROMESA and CEPEP)107,000 132,000 145,000 156,000 Quality service delivery points
providing services in priority
regions0 15 30 U.S. Finance Table (Microsoft Excel file)
ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Key Democratic Governance Practices Instituted, 526-004
PLANNED FY 2000 OBLIGATION AND ACCOUNT: none
PROPOSED FY 2001 OBLIGATION AND ACCOUNT: $3,100,000 (DA), $3,500,000 (ESF)
STATUS: Continuation of current Strategic Plan FY 1997-2000. New Strategic Plan FY 2001-2005.
INITIAL OBLIGATION: FY 2001 ESTIMATED COMPLETION DATE: FY 2005Summary: As this young democracy came to a crossroads in March 1999, for the first time it was an active civil society that tipped the political balance against reverting to authoritarian rule. Although the democratic system of government ultimately prevailed, these events and actions clearly demonstrate the continued fragility of Paraguayan democracy and the need to shore up its foundations to build future security and preserve stability in the region. Based upon USAID/Paraguay resources, its analysis of existing problems, and of the potential to achieve a significant and sustainable impact in Paraguay, the Mission has developed its current strategy aimed at strengthening the country's democracy.
The new Strategic Objective plans to build on and move beyond the Mission's current strategy of strengthening selected key democratic institutions to achieve a second generation of reforms based on improving democratic governance practices. Examples of these key governance practices highlighted in the new democracy SO are transparent, participative decision-making; open, clear government management practices; a strong, active civil society; improved and responsive delivery of public services; and serious, thoughtful discussions on basic democratic issues at national and local levels.
Key Results: Three key intermediate results will be achieved in the new Strategic Plan. 1) More effective and accountable local governments developed to provide better services that are responsive to their citizenry. 2) Informed citizens that participate more actively and effectively in increasingly democratic and transparent policy formulation. And 3) national democratic reform and decision-making at both local and national levels are more transparent and inclusive.
Performance and Prospects: Under the new Strategic Plan, USAID/Paraguay hopes to increase the ability of targeted local governments to plan, manage, and generate additional resources, and thus improve their capacity to deliver services. The Mission will also work to improve local government capacity by strengthening local government organizations, and developing systems for improved management and technical skills. Additionally, the Mission will work to increase transparency and citizen participation while at the same time reducing the opportunities for corruption at the local government level. Finally, this strategy will work towards clearly defining and expanding the role of local governments by increasing their authority through greater decentralization of resources, decision-making, and basic public service delivery.
Developing an active civil society will increase citizen participation, both at individual and organizational levels, in the public decision making process. Activities in this area will include the continuation and expansion of public forums and debates on a variety of issues with locally and nationally elected representatives. This also seeks to increase the effectiveness and activity of citizens and civil society organizations so they can obtain needed services and influence national policy. This builds upon the Mission's current local-level participatory planning activities, such as designing community development plans, supporting local health councils, and promoting public municipal budget hearings.
Increased citizen participation in policy processes and in the oversight of public institutions will be achieved. In addition, civil society organizations (CSOs) will be better able to monitor and pressure for transparency and reduced corruption in government functions. The Mission will carry out strategies and activities to increase the institutional viability and sustainability of CSOs. This will include improving their internal financial management systems and diversifying their income base.
Expanding the national democratic reform process represents the continuation of efforts from the Mission's current Strategic Plan, as well as focusing on the unique opportunities that are available due to circumstances surrounding the recent political upheaval and change in government. There is a critical need and urgency to engage the GOP in a national dialogue that leads to clear activities that are implemented. The Mission's support is focused in strengthening democratic practices to meet the goals of an informed and active civil society and by pushing the Reform of the State program in order to obtain a development agenda that serves the national interests.
Possible Adjustments to Plans: In September 1999, the Mission received approval of its new Strategic Plan that will begin in FY 2001.
Other Donor Programs: USAID has taken the lead in encouraging the donor community to support democracy, especially with the Inter-American Development Bank (IDB). Using USAID-initiated studies, the IDB has designed approximately $72 million in complementary projects to help modernize the State, to strengthen the judicial branch ($8.4 million), and provide assistance to the congress estimated at ($500,000). The IDB is also executing a $18 million municipal strengthening project aimed mainly at designing new urban cadasters. The World Bank has a pending $20 million infrastructure loan to the Municipality of Asuncion. The Organization of American States (OAS) has worked closely with USAID in election assistance and has spent approximately $800,000 since 1996 to support the electoral process. The German Technical Cooperation Agency (GTZ) is implementing a penal reform activity ($1.7 million) and a modernization of the Civil Registry ($4 million). Taiwan is lending $20 million to construct a new building for the Congress. And, the European Union has judicial, legislative, and state reform projects ($3 million).
Principal Contractors, Grantees, or Agencies: : USAID implements activities through several U.S. and local organizations. U.S. principal contractors and grantees are the International Foundation for Electoral Systems (IFES), Development Alternatives Inc. (DAI), and the National Center for Courts (NCSC). Local NGOs and grantees include the Information and Resources Center for Development (CIRD), the Paraguayan Center for Economic Liberty and Social Justice (CEPPRO), and Alter Vida.
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)Percentage of population who
express satisfaction with local
government service delivery.53 N/A N/A 65 Number of civil society
organizations showing improvements
in the CSO index.0 N/A N/A 5
U.S. Finance Table (Microsoft Excel file)
ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Sustainable Management of Globally Important Ecoregions Improved, 526-005
PLANNED FY 2000 OBLIGATION AND ACCOUNT: none
PROPOSED FY 2001 OBLIGATION AND ACCOUNT: $1,000,000 (DA)
STATUS: Continuing
INITIAL OBLIGATION: FY 2001 ESTIMATED COMPLETION DATE: FY 2005Summary: USAID contributes to the sustainable development of Paraguay by promoting environmentally sound practices of natural resources management. A significant percentage of the land in the country is owned by large private landowners who use the land for unsustainable agriculture and livestock practices. The new Environmental Strategic Objective will support both global and regional priorities. First it will support the Agency's global environmental objectives of biological diversity conservation and climate change amelioration by protecting forests and wetlands that store carbon. The SO will also strengthen and complement USAID/Bolivia's efforts to conserve the important ecosystems in the Chaco and the Pantanal, USAID/Brazil's and LAC's recent investments in the Pantanal and the Interior Atlantic Forest region, as well as the activities of Argentina with the Interior Atlantic Forest.
Key Results: Two key intermediate results will be achieved under the new Strategic Plan. 1) Paraguayan leaders will be trained and targeted NGOs will be strengthened, and 2) the necessary policy, legal, and financial tools will be developed by Paraguayan NGOs, civil society organizations (CSOs), and municipal, central and departmental authorities with the required skills for competent participation in these efforts. This will improve the overall sustainable management and protection of globally important ecoregions shared with neighboring countries. Democracy will also be strengthened in Paraguay through the further development of an active civil society, improved local government capacity, and greater stability through environmental protection.
Performance and Prospects: Paraguay, with one of the highest rates of deforestation in the world, continues to lose 10% of its remaining forest cover every year, threatening the future of unique regional ecosystems. Because environmental problems aggravate poverty and complicate the transition to democracy, it is imperative that Paraguay develop and implement sustainable land use models and preserve the last remnants of these important ecosystems.
At the new Strategic Objective level, development of ecoregional conservation plans will include a series of stakeholder analyses, biodiversity and socio-economic assessments, international planning workshops, and inter-governmental review of ecoregional conservation plans. USAID/Paraguay will facilitate and ensure the dissemination of known and emerging lessons learned, including provided by other donor activities.
Many Paraguayan NGOs and CSOs still have limited capacity to be financially self-sufficient. Some of these institutions, however, own the potential and the interest in participating in this regional effort and effectively influencing in how the conservation of these key ecoregions will be implemented. Technical assistance and training, advocacy skills and management improvement are still needed to better coordinate with regional and local efforts to achieve a better impact under this strategic objective.
Local governments also often lack the requisite technical abilities and environmental awareness to effectively contribute to environmental management. Given other donor support to the national government, and the growing trend towards the decentralization of power, USAID/Paraguay will assist in developing environmental leaders at departmental and municipal levels. NGOs and civil society strengthening are a current focus of USAID/Paraguay programming and will continue to be emphasized across the Mission's SOs.
Conservation effectiveness in Paraguay is currently limited by policy, legal, and financial constraints. In order for ecoregional conservation plans to be completed and implemented, it is imperative that Paraguay develop the necessary mechanisms to support them. This directly complements planned Mission activities in democracy directed at implementing and sustaining a policy dialogue on key national issues. Legal, regulatory and policy changes will be targeted in Paraguay, based on ecoregional conservation plans, bi-lateral treaties, and Mercosur agreements. These policy changes may include improving legislation for private land reserves, ensuring public participation in the environmental impact assessment process, and promoting legislative changes which allow citizens to bring suit against those ignoring environmental laws. The Mission will also encourage compliance with current environmental legislation and will convene an Environmental Donors Roundtable, similar to the one already operating in Bolivia, to ensure better coordination and to better leverage advocacy efforts for national government policies. USAID/Paraguay will also facilitate a policy dialogue at the regional level and support regional-level environmental legislation.
Possible Adjustments to Plans: New programming directions are reflected in the FY 2001 - FY 2005 recently approved Strategic Plan. Ecoregional conservation initiatives involving neighboring countries will be promoted.
Other Donor Programs: Other donors continue to be highly involved, in close coordination with USAID, in the conservation of natural resources activities in Paraguay. All donors are working directly with the GOP and in most cases also with local NGOs. The Global Environmental Facility (GEF) is involved in the protection of ecosystems of regional and global importance in Paraguay through a $9 million project. The Japanese International Cooperation Agency is trying to diminish the severe deforestation problem that Paraguay faces with a $7 million forestation project. The German Technical Cooperation Agency is implementing a $3.8 million effort to elaborate a National Action Plan for the protection of natural resources. The European Union is supporting a $18 million Sustainable Development Project for the western region of the country.
Principal Contractors, Grantees, or Agencies: USAID implements activities through The Nature Conservancy (TNC), World Wildlife Foundation (WWF), and two local NGOs, the Moises Bertoni Foundation and the Desdel Chaco Foundation.
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)Number of ecoregional conservation
plans developed, approved, and
implemented with adequate
Paraguayan participation.0 0 N/A N/A 1 Number of targeted NGOs and
CSOs strengthened.0 0 N/A N/A 2
U.S. Finance Table (Microsoft Excel file)
ACTIVITY DATA SHEET
PROGRAM: Paraguay
TITLE AND NUMBER: Use of Voluntary Reproductive Health Services Increased, 526-006
PLANNED FY 2000 OBLIGATION AND ACCOUNT: none
PROPOSED FY 2001 OBLIGATION AND ACCOUNT: $3,900,000 (DA)
STATUS: Continuation of current Strategic Plan FY 1997-2000. New Strategic Plan FY 2001-2005.
INITIAL OBLIGATION: FY 2001 ESTIMATED COMPLETION DATE: FY 2005Summary: Reproductive health care is important in Paraguay because of a desire to solve two acute problems in the area of human reproduction: 1) the unacceptable levels of maternal mortality and infant mortality (69% of which is attributable to preventable disease) and 2) excessively high levels of fertility (4.1). Effective health care delivery at the community level can be strengthened by channeling services through local democratic institutions. A significant foundation for improved decentralized health services design and delivery at the municipal level has already been created with USAID/Paraguay support. This decentralization of the provision of health services complements efforts to strengthen democratic processes, while effectively addressing health concerns.
The new Strategic Plan, while strengthening existing public and private family planning programs, envisions a larger program of reproductive health initiatives. It involves a multi-institutional approach that will augment delivery of both reproductive health and family planning services to rural and urban adolescents, single adults, and couples. In order to further strengthen its reproductive health program, the Mission will direct activities towards reducing Paraguay's maternal mortality rate through the provision of enhanced reproductive health services and maternal health care, thereby also improving neo-natal survival rates.
Key Results: Two intermediate results will be achieved under this Strategic Objective. 1) Decentralized community based health care will be provided. And 2) access to quality reproductive health services will be expanded.
Performance and Prospects: A national reproductive health survey has demonstrated that contraceptive prevalence for women between the ages of 15 and 49 using modern methods has gone from 35% in 1990 to 49% in 1998. This upward trend is expected to continue and reach the target of 50% prevalence by the end of FY 2000. Couple years of protection (CYP) is expanding as a result of contraceptives supplied by the Government of Paraguay and the private sector. Activities to assist the private sector organize cost-effective services are being carried out through local NGOs and U.S. cooperating agencies. USAID's support for expanded access to family planning services includes the expansion of community-based and alternative distribution systems, including an innovative contraception social marketing program, to reach underserved rural and marginal urban areas. In addition, program efficiency and sustainability are addressed through training and technical assistance in contraceptive logistics management, specialized clinical training, financial and program management, and closer coordination between the public and private sector.
In its new Strategic Plan, USAID/Paraguay will build on its past programming, maintaining a focus on increasing access to and use of reproductive health services. USAID/Paraguay will also focus on improving decentralized community health care, increasing community participation, improving local-level management of health providers, and building NGO capacity. Technical assistance will be directed at services provided through local governments and the private sector, including continued support of health decentralization. The Mission will strengthen community outreach programs, including the development of a Reproductive Health-specific promotion campaign and will continue to enhance donor coordination. The Mission's Reproductive Health Strategic Objective is closely linked with its Democracy Strategic Objective, and activities will be mutually reinforcing.
With the implementation of health decentralization now in progress at all levels and the continued downward transfer of both authority and responsibility, the Mission believes that a framework exists for improved delivery of basic reproductive health services. Other multilateral donors, NGOs, and private sector providers will be engaged in extending coordinated reproductive services to appropriate components of the Paraguayan population. The division of labor (both geographical and categorical) among all contractors should enable widespread coverage of the populated areas of Paraguay.
The MOH has recently finalized a new National Reproductive Health Plan for the country. USAID/Paraguay will, in coordination with national-level authorities, including the Technical Planning Secretary, the National Women's Secretary, the Ministry of Health (MOH) and others, support the effective implementation of this and other national-level policies throughout the country. However, local health councils will be an integral part of community participation activities related to health planning. The Mission will build on current successes in increasing community participation in the health sector, as well as in other areas. Strengthening community participation, through local health councils and other appropriate means, will result in the delivery of appropriate services that meet local demands. Strengthened participation in health service delivery will contribute to more transparent public management in general and the creation of an empowered civil society.
The Mission also plans to implement a demonstration model of a maternal health system. The model uses design teams whose members include local MOH officials, hospital and clinic health administrators, health providers, traditional birth attendants, and community members. These teams identify the most significant barriers to the provision of quality maternal health services and devise local solutions to their problems. Interventions are directly aimed at increasing the demand for services through information, education, and communication activities and assuring essential obstetric care is provided to women during pregnancy and childbirth.
Possible Adjustments to Plans: The Mission's new Strategic Plan was approved in September 1999.
Other Donor Programs: USAID/Paraguay is assuming a leadership role in donor coordination and is leveraging additional resources toward key reproductive health results and is developing new approaches that can be followed by other partners. The World Bank has budgeted $22 million to decrease maternal and infant mortality in six departments in rural areas of Paraguay through improved hospital facilities and equipment, mobile health clinics, procurement of medicine and supplies, human resources training, and other activities with community outreach. The Inter-American Development Bank (IDB) is planning a similar $38 million loan to provide a parallel range of services in five additional rural departments. USAID will carry out demonstration projects that both of these banks can replicate on a larger scale.
The Pan-American Health Organization (PAHO) in Paraguay is working in health sector reform; the institutional development of the MOH; epidemiological surveillance of infectious diseases; and, health promotion and prevention in maternal, child and mental health. PAHO also provides technical cooperation to the MOH for regional health initiatives. The Mission collaborates closely with PAHO on policy development.
The United Nations Fund for Population Activities (UNFPA) is a key partner in the strategic plan. Success in attaining family planning goals is facilitated by UNFPA's assurance of continued provision of contraceptive materials through 2002 and possibly beyond. PAHO and the United Nations Children's Fund (UNICEF) also provide technical assistance to primary care programs in family planning and reproductive health. The International Planned Parenthood Federation (IPPF) provides funding to its local affiliate, for both administrative and program costs and the German Technical Cooperation Agency (GTZ) provides support for a targeted adolescent reproductive health program.
The Japanese International Cooperation Agency (JICA) has been disbursing approximately $1.5 million per year to develop a decentralized health management model in the Department of Caazapa and is coordinating with USAID and the GOP under the U.S.-Japan Common Agenda to realize recommendations in reproductive health, such as training midwives and conducting information, education and communication campaigns.
Principal Contractors, Grantees, or Agencies: USAID implements the program through the following U.S.-based organizations: Population Services International (PSI), Access to Voluntary and Safe Contraception (AVSC), Johns Hopkins University (PCS-JHU), the University of North Carolina, and the Centers for Disease Control (CDC). Local organizations funded by the Mission are the Paraguayan Center for Population Studies (CEPEP), the Information and Resources Center for Development (CIRD), and Promotion for Health Improvement (PROMESA).
Selected Performance Measures: Baseline
(1996)Actual
(1998)Target
(1999)Target
(2000)Target
(2001)Contraceptive prevalence for women
15-49 using modern methods49% N/A N/A 51% Couple years of contraceptive
protection (Ministry of Health,
PROMESA and CEPEP)132,000 N/A N/A 167,000 Quality service delivery points
providing services in priority regions0 N/A N/A 40
U.S. Finance Table (Microsoft Excel file)
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Last Updated on: January 18, 2001 |
