USAID: Liberia FY 2002 Congressional Budget Justification

PROGRAM: Liberia
TITLE AND NUMBER: Increased Use of Essential Primary Health Care (PHC) Services Through Civil Society, 669-003
STATUS: New
PLANNED FY 2001 OBLIGATION AND FUNDING SOURCE: $850,000 DA; $1,350,000 CSD
PROPOSED FY 2002 OBLIGATION AND FUNDING SOURCE: $500,000 DA; $1,500,000 CSD
INITIAL OBLIGATION: FY 2001 ESTIMATED COMPLETION DATE: FY 2003

Summary: This special objective will contribute directly to USAID's goal of promoting a greater role for civil society in a successful transition towards improved social, economic, and political conditions in Liberia. The objective integrates and supports maternal, reproductive and child health services, including HIV/AIDS. USAID will engage the participation of Liberian partners, especially civil society in the development and implementation of critical health services. This approach to improving access, demand and quality of these services will encourage international organizations to promote a greater role for indigenous organizations. As participating organizations become more empowered, more civic-action oriented, and strong advocates for demanding health care services from the government, a platform for influencing broader democratic governance at the national level becomes more likely.

In 1989, only 35% of the population had access to health services. Maternal mortality is among the highest in Africa, with the current maternal mortality estimated at 780 per 100,000. Immunization rates for children below two years of age for all childhood diseases were 21% in 1997, while only about 28% of women 14-49 years old had received tetanus vaccination. Regarding malnutrition, the problem seems to be that of stunting rather than wasting, with moderate malnutrition at 56 percent, severe malnutrition at 6.1 percent and stunting at 18.5 percent (1997). There is also a growing concern that given the upward trend in prostitution and child sexual abuse, coupled with the high population mobility, especially during and since the civil war, HIV/AIDS prevalence may be a time bomb waiting to explode.

In FY 2001, USAID plans to obligate ($850,000) Development Assistance population funds and ($1,350,000) Child Survival Program funds ($500,000 polio). USAID assistance will fund International and non-government organizations to integrate and support maternal, reproductive and child health services, including HIV/AIDS.

In FY 2002, USAID anticipates providing ($500,000) Development Assistance population funds and ($1,500,000) Child Survival Program funds ($500,000 polio) for this objective. USAID assistance will fund International and non-government organizations by integrating and supporting maternal, reproductive and child health services, including HIV/AIDS.

Agreements under this notification will incorporate clauses that implement the President's recent directive reinstating the Mexico City Policy.

Key Results: The results achieved under the FY 1997-2000 Transition Strategy include the provision of basic health care services to 1,307 remote communities with an estimated population of more than 1.5 million inhabitants in seven of Liberia's counties. Under this new special objective an estimated 269,782 children under age 5 continue to receive child survival services; 317,391 women of child-bearing age are targeted for reproductive (family planning)/maternal health services; and about 249,152 adolescents, 13-24 years of age, have been targeted for sexually transmitted disease and HIV/AIDS prevention and control services.

Performance and Prospects: The activities in support of this strategic objective are crucial to the recovery process and will facilitate the delivery of basic health care, primarily in rural areas. Assistance will focus on sustaining conditions for resettlement and building the capacity of local organizations to help deliver assistance, working primarily through international organizations. Activities will be selected as those that will have the greatest immediate impact on the health of the Liberian people while also developing the needed capacity and infrastructure to deliver these services.

Possible Adjustment to Plans: Under the new Transition Strategy (2001-2003), activities will be designed so that they complement and add value to activities planned under the democracy/governance (D/G) and agriculture special objectives. This means that the focus will be on working with the organizations that develop radio programs on D/G and health activities including HIV/AIDS prevention and control to facilitate community empowerment and partnership. It is anticipated that during the transition period, each international organization will build the foundation for Liberian ownership of health interventions and strengthen the prospects for sustaining the program in spite of future uncertainties.

Other Donor Programs: The European Union is revitalizing primary health care services in the southeastern region of Liberia. The European Union and the United Nations Children's Fund (UNICEF) are supporting the National Drug Service to ensure the availability of essential drugs in public health institutions. UNICEF and the World Health Organization (WHO) are providing vaccines and supplies for the Expanded Program for Immunization as well as technical and logistical support to the Ministry of Health for health services revitalization. Other major bilateral and multilateral donors include the Netherlands, Sweden, Denmark, France, the United Kingdom, Japan, Taiwan, Canada, the World Bank and the International Monetary Fund.

Principal Contractors, Grantees or Agencies: Current grantees and contractors include Africare, International Rescue Committee, Save the Children Fund, United Nations Children's Fund, World Health Organization, and World Vision International.

FY 2002 Performance Tables

U.S. Financing

(In thousands of dollars)

	Obligations		Expenditures		Unliquidated
Through September 30, 1999	0	DA	0	DA	0	DA
	0	CSD	0	CSD	0	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA
Fiscal Year 2000	0	DA	0	DA
	0	CSD	0	CSD
	0	ESF	0	ESF
	0	SEED	0	SEED
	0	FSA	0	FSA
	0	DFA	0	DFA
Through September 30, 2000	0	DA	0	DA	0	DA
	0	CSD	0	CSD	0	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA
Prior Year Unobligated Funds	0	DA
	0	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
Planned Fiscal Year 2001 NOA	850	DA
	1,350	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
Total Planned Fiscal Year 2001	850	DA
	1,350	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
			Future Obligations		Est. Total Cost
Proposed Fiscal Year 2002 NOA	500	DA	0	DA	1,350	DA
	1,500	CSD	0	CSD	2,850	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA

LIBERIA

Activity Data Sheet

FY 2002 Performance Tables

U.S. Financing