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GUINEA
Activity Data Sheet
>> AFR Regional Overview >> Guinea Overview PROGRAM: Guinea
TITLE AND NUMBER: Increased Use of Essential Family Planning/Maternal Child Health and Sexually Transmitted Infections/AIDS-Prevention Services and Practices, 675-002
STATUS: Continuing
PLANNED FY 2001 OBLIGATION AND FUNDING SOURCE: $2,230,000 DA; $4,360,000 CSD
PROPOSED FY 2002 OBLIGATION AND FUNDING SOURCE: $2,460,000 DA; $4,552,000 CSD
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2005Summary: With the aim of contributing to the stabilization of the world's population and protecting human health, USAID developed a Health Strategic Objective (SO) in 1997 in support of the Government of Guinea's health policy. The goal of the SO is to improve the health status of the Guinean population through increased access to and improved quality of health services and products, along with the promotion of positive behavior change among the population. Furthermore, the Mission strives to improve donor collaboration in both the public and private sectors to develop effective, sustainable responses, given the critical health constraints of the country. The ultimate customers of the health activities are women of childbearing age (15-49) including pregnant women, children under five and sexually active adults and adolescents.
The Health SO is meeting expectations as demonstrated by the positive gains recorded during this reporting period in relation to established benchmarks. In FY 2000, Child Survival and Diseases (CSD) funds were used to improve the routine immunization program, expand the availability of child survival products and implement the integrated management of childhood illness (IMCI) strategy. These funds were also used to improve the nutritional status of children, develop a "safe motherhood" strategy, increase the availability of sexually transmitted illness (STI) prevention services, raise HIV/AIDS awareness, and promote the use of condoms for HIV/STI prevention. Development Assistance (DA) funds were used to provide high-quality family planning (FP) services, with a particular emphasis on community-based programs; conduct a media campaign targeting men's involvement in FP decisions; procure contraceptives; and strengthen Guinea's contraceptive logistics system.
In FY 2001, USAID plans to obligate ($2,230,000) Development Assistance funds for population activities and ($4,360,000) of Child Survival and Diseases (CSD) of which ($2,158,000) include Child Survival activities; ($250,000) Polio activities; and ($2,202,000) HIV/AIDS activities.
In FY 2002, USAID anticipates providing ($2,460,000) Development Assistance funds for population activities and ($4,552,000) of Child Survival Activities and Diseases. Donor and government coordination resulted in the adoption of a national Safe Motherhood Strategy. USAID assistance will strengthen and develop an action plan for IMCI, implementation of an exhaustive review of Guinea's immunization program, and realization of a nationwide anemia study (CSD) funded.
Agreements under this notification will incorporate clauses that implement the President's recent directive reinstating the Mexico City Policy.
Key Results: USAID's leadership and effectiveness in developing strong donor and government coordination resulted in the adoption of a national Safe Motherhood Strategy (focussing on essential obstetric care), development of an action plan for IMCI, implementation of an exhaustive review of Guinea's immunization program, and realization of a nationwide anemia study (CSD) funded. Guinea became the first country in West Africa to achieve the global targets for polio eradication thanks to USAID's support as the lead donor agency in this activity (CSD) funded. The success of USAID's community-based child nutrition activity (Hearth) led other donors and PVOs to expand this program elsewhere in Guinea (CSD). Increased acceptance of FP resulted in a 37% increase in new clients in USAID targeted areas and in couple years of protection (CYP) exceeding expectations (DA) funds.
Performance and Prospect: Toward the end of FY 2000, a significant segment of USAID's health program was affected by border incursions into Guinea by rebel forces from Sierra Leone and Liberia, and the subsequent mass displacement of over 250,000 refugees and 150,000 internally displaced people (IDPs) from the area. The Mission's major implementing partner withdrew its international staff from the zone of conflict and then closed down its Nzerekore regional office, and reduced local staff and activities in the Faranah Region. The social marketing program also suspended activities in the Forest Region, moving staff and equipment to Upper Guinea. USAID and its partners recognize that regular activities in the conflict areas will not likely be resumed soon, and, therefore, is revising plans to reflect new staffing configurations and refocused activities.
In FY 2000, access to FP services surpassed targets. Contraceptive services and/or products are now available in 96% of targeted health centers (174 in Upper Guinea and the Forest Region), and through the private sector in 89% of sub-prefectures throughout the country. When United Nations Population Activity (UNFPA)'s funding for contraceptives ended in FY 2000, USAID became solely responsible for ensuring the availability of a full range of FP methods for the public health sector. Concerned about the sustainability of the program, USAID is strengthening the Ministry of Health (MOH)'s contraceptive logistics system, tracking contraceptive stock-outs in health centers, and working with the MOH to institute cost recovery mechanisms. Population Services International (PSI)'s partnering with local commercial wholesalers and distributors is expected to increase coverage and condom sales in the private sector in the coming years.
Demand for FP products also continued to show dramatic improvement. CYP surpassed 87,000, and sales of condoms in the private sector increased by over 27% in FY 2000, to almost 5.6 million condoms sold. Consequently, USAID is revising targets upward for CYP. USAID's partners also initiated a broad range of creative Information, Education and Communication (IEC) activities targeted at youth, including a popular radio call-in show, concerts with local musicians, and soccer games during which abstinence and condom use are promoted. Given their enormous influence in the community, religious leaders continue to be the focus of behavior change activities in the areas of HIV prevention and FP.
While USAID's partners made progress in Maternal Child Health (MCH) at the community level, the Mission determined that complementary targeted interventions were necessary in order to ensure timely strengthening of the regional link in the MCH network. Two factors supporting this determination were: 1) activity implementation at the regional level had been slower than anticipated during the 1997 - 2000 period; and 2) more work needed to be done in the realm of central-level policy development in order for the regional level to be fully effective.
With technical assistance from the Johns Hopkins Program for International Education in Reproductive Health (JHPIEGO), USAID worked closely with the MOH to review its Maternal Health (MH) policies and develop the safe motherhood strategy. This strategy will form the basis for USAID's activities to improve the quality of MH services at the community and health center levels. In child health, USAID brought in Basic Support for Institutionalizing Child Survival (BASICS) to coordinate the development of an IMCI strategy and action plan. As a result, USAID, the MOH, UNICEF and other partners will adapt training modules and implement IMCI pilot projects this year. In collaboration with the MOH, USAID through Helen Keller Worldwide (HKI) succeeded in implementing a nationwide anemia study. By successfully leveraging funds from the World Bank and the private sector, HKI was able to expand the age group of the study to include children and youth aged 0-18, making it the most comprehensive anemia study to date in West Africa. Results of this study will be used to strengthen USAID's micronutrient and IEC activities. In September 2000, a yellow fever outbreak occurred in the center of the country, resulting in more than 200 deaths to date. USAID has actively supported the Government of Guinea (GOG)'s immunization campaign, and participates on a technical committee focused on improving Guinea's response to this and other epidemics.
USAID's interventions to reduce HIV infection, including the integration of STI/HIV prevention services at nearly 100% of USAID-targeted health centers, IEC activities, social marketing of condoms and increased points of sale, are working to create greater awareness and promote positive behavior change among the Guinean population. However, Guinea's proximity to high prevalence countries, its enormous refugee and IDP populations, and the instability of the sub-region are critical factors that indicate that the country's HIV problem may be more significant than MOH planners suggest. USAID recognizes that its current activities are not enough to avert a potential AIDS crisis in Guinea. Therefore, USAID is developing a more comprehensive strategy to prevent the spread of HIV. This strategy will intensify the targeting of high-risk populations, such as miners, the military, prostitutes, and adolescents; focus on other high-risk groups like transporters; and expand prevention efforts beyond the health sector and into the education, agriculture, and micro-finance sectors.
This year USAID, the World Bank, UNFPA, and the MOH will fund and implement a sero-prevalence study and will strengthen the national HIV sentinel tracking system. USAID now requires all SO teams in Guinea and their implementing partners to present HIV/AIDS messages or conduct HIV/AIDS prevention activities when sponsoring any USAID-financed event.
Possible Adjustments to Plans: USAID has undertaken a strategic planning process, including a Democratic Health Survey (DHS), a diagnostic of the social marketing program, a review of the immunization program, and a health facility survey. This process will continue in FY 2001 with an evaluation of SO2's public sector health activities and an HIV sero-prevalence study. The result of these efforts, along with analysis of the security situation, will form the basis for defining follow-on activities beginning in January 2003 through the end of the country strategic plan (FY 2005).
Other Donor Programs: The World Bank, World Health Organization (WHO) and United Nations Children's Funds (UNICEF) are important partners in MCH and contribute to improving the routine immunization program. Japan supplies all vaccines. The World Bank and German Technical Cooperation (GTZ) provide STI treatment equipment and pharmaceuticals in health centers, and German Development Bank (KFW) co-funds, with USAID, private sector social marketing activities.
Major Contractors and Grantees: Management Sciences for Health (MSH) and John Hopkins University Center for Communication Programs (JHUCCP) train health care providers and administrators; implement IEC activities; and provide logistics and management technical assistance to the MOH. PSI is the social marketer for the private sector. Africare trains community members in health promotion.
FY 2002 Performance Tables
Performance Measures:
Indicator FY97 (Actual) FY98 (Actual) FY99 (Actual) FY00 (Actual) FY00 (Plan) FY01 (Plan) FY02 (Plan) Indicator 1: DPT3 Vaccine Coverage NA NA 46.2% 53% 58% 63% 68% Indicator 2: % of Sub-prefectures with FP and Health Products Points of Sale NA 31% 73% 89% 80% 95% 100% Indicator 3: Couple Years of Protection (CYP) 38,909 44,819 70,045 87,068 80,000 105,000 125,000 Indicator 4: Measles Vaccine Coverage NA NA 44.2% 37% 58% 63% 68% Indicator Information:
Indicator Level (S) or (IR) Unit of Measure Source Indicator Description Indicator 1: IR Numerator: Total number of children received DPT3 vaccination. Denominator: Total number of children ages 12-23 months. Macro, BASICS, Stat-View or other field support partner Percentage of children aged 12-23 months who received DPT3 vaccination. Indicator 2: IR Percentage of all Guinean sous-prefectures that have a point of sale for family planning and/or health products. PSI points of sales report and sales statistics Sous-prefectures which contain a functional point of sale for FP and/or health products. Total number of Sous-prefectures. Indicator 3: S The total contraceptive protection provided by family planning programs in Guinea expressed in terms of couples protected for one year. MOH/PRISM service statistics, MOH/UNFPA service statistics; OSFAM/PSI sales to vendors statistics Based upon volume of all contraceptive commodities distributed to warehouses, vendors or clients in one year by family planning /social marketing programs. Indicator 4: S Numerator: Total number of children aged 12-23 months who received measles vaccination before one year of age. Denominator: Total number of children of age 12-23 months Macro, BASICS, Stat-View or other field support partner. Nationally representative household survey such as DHS or KAP, Standard WHO 30 cluster sample survey. Percentage of children aged 12-23 months who received measles vaccination before one year of age
U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 10,275 DA 8,700 DA 1,575 DA 13,739 CSD 12,103 CSD 1,636 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 15,051 DFA 15,051 DFA 0 DFA Fiscal Year 2000 2,800 DA 1,499 DA 4,975 CSD 2,653 CSD 0 ESF 0 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 13,075 DA 10,199 DA 2,876 DA 18,714 CSD 14,756 CSD 3,958 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 15,051 DFA 15,051 DFA 0 DFA Prior Year Unobligated Funds 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 2,230 DA 4,360 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 2,230 DA 4,360 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 2,460 DA 0 DA 17,765 DA 4,552 CSD 6,000 CSD 33,626 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 6,000 DFA 21,051 DFA
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Last Updated on: May 29, 2002 |
