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WEST AFRICA REGIONAL PROGRAM
Activity Data Sheet
>> AFR Regional Overview >> WARP Overview Program: WEST AFRICA REGIONAL
Title and Number: Increased, Sustainable Use of Selective Reproductive Health, STI/HIV/AIDS, Child Survival and Maternal Health Services and/or Products in West Africa, 624-005
Status: New
Planned FY 2001 Obligation and Funding Source: $10,692,000 CSD; $8,195,000 DA
Proposed FY 2002 Obligation and Funding Source: $11,509,000 CSD; $7,875,000 DA
Initial Obligation: FY 2001 Estimated Completion Date: FY 2008Summary: Health and living standards indices consistently rank countries of West Africa among the poorest in the world. Child mortality-though greatly improved over the past four decades-remains above 100 per 1000 live births. Maternal mortality exceeds 700 per 100,000 live births. Additionally, HIV/AIDS and other infectious diseases pose acute threats and freely cross borders owing to the high levels of sub-regional migration. West Africa can no longer be considered a low HIV prevalence region as all the countries in the region, except Mauritania, have generalized epidemics, and several countries are presently, or will soon be, facing double digit epidemics (Côte d'Ivoire - 11%, Cameroon - 8%, Togo - 6%). Despite improvements in most health indicators, weak capacity of public and private sector organizations, poor quality of health services, and insufficient public knowledge of and demand for preventive health measures and services remain daunting constraints. In effect, limited indigenous resources or commitment and the transnational nature of most health problems have shaped the approaches and results of USAID's efforts in this region.
This activity focuses on increasing the sustainable use of selected products and services in the areas of reproductive health, sexually transmitted infections, HIV/AIDS, and child survival in West Africa. It will do so by addressing the constraints of poor service delivery, limited technical and management leadership in the health sector, lack of knowledge of best practices and state of the art technologies, and the fragmented use of public and private sector financial and human resources. USAID together with other donors will provide their technical expertise in: advocacy and policy dialogue; capacity building and training; operations research; information, education and communication; social marketing; population policy analysis and development; and logistics management. Finally, USAID will also seek to leverage and mobilize additional resources for health within the region.
This activity contributes to the achievement of USAID Agency goals in global health and the U.S. National Interest of "Population and Health, AIDS Prevention" as defined by the Strategic Plan for International Affairs Agencies (SPIAA).
In FY 2001, Child Survival and Disease (CSD) funds of $2,499,000 ($2,000,000 child survival and $499,000 infectious diseases) will be used to: (1) finance social marketing of oral rehydration salts (ORS) and support the distribution of related information, education and communication activities that contribute to the control of child morbidity and mortality associated with diarrhea; (2) prevent and control malaria within the context of essential obstetric care and conduct applied research to add to the body of knowledge in the region regarding effective malaria treatment and prevention; (3) strengthen health delivery systems through improved operational capacity for national and regional partner institutions; and (4) improve maternal health through essential obstetric care. HIV/AIDS funds totaling $8,193,000 from the CSD account will be used to finance expanded HIV prevention and control efforts in the region, with a special emphasis on condom social marketing and cross-border HIV/AIDS prevention activities targeting highly vulnerable groups.
Development Assistance (DA) funds totaling $8,195,000 will be used to increase access to and use of quality family planning services through selected service clinics. Family planning agreements under this notification will incorporate clauses that implement the President's recent directive reinstating the Mexico City Policy.
In FY 2002 DA and CSD funds totaling $19,384,000 will be used to continue those programs and initiatives from previous years. A focus will be on re-orienting service delivery and training efforts for family planning and HIV/AIDS; and facilitating increased donor coordination on HIV/AIDS funding and programs in the region.
Key Results: This activity is designed to continue and expand upon the efforts of Activity 624-001, Increased Use of Selected, Regional Reproductive Health, HIV/STI, and Child Survival Services and/or Products in the West Africa Region, which is known as the Family Health and AIDS (FHA) project. This predecessor activity, begun in FY 1995 and funded through FY 2000 has achieved, among many other accomplishments: (1) significant increases, since the activity's inception, in levels of knowledge and use of modern contraceptives and ORS in the activity's focus countries, and (b) major increases in condom use for both regular and occasional partners through a sub-activity targeting migrants, truckers, and prostitutes.
Performance and Prospects: Through this WARP activity, USAID will focus on a number of issues during FY 2001. It will re-orient service delivery and training efforts begun under the FHA activity; "dual protection" approaches will be incorporated for better health outcomes. Additionally, USAID will support establishment of centers of excellence in HIV voluntary counseling and testing and will reorient syndromic management of sexually transmitted infections toward clinical settings that serve high-risk populations. In FY 2001, public awareness radio campaigns in French and local languages will be produced and broadcast on basic diarrhea case management with an oral rehydration therapy/ORS component.
The Family Health and AIDs in West and Central Africa (FHA) Project has worked bilaterally and regionally with several donors in leveraging resources and in support of joint activities. At the regional level, FHA has worked collaboratively with the African Develoment Bank, the Joint United Nations Program on HIV/AIDS (UNAIDS), the United Nations Children's Fund and the World Bank. At the national level, the project collaborates with bilateral donors such as Germany, which have been increasingly funding contraceptives where USAID funding has ceased, and United Nations agencies such as UNAIDS, the World Health Organization and the United Nations Population Fund (UNFPA).
Prospects for the future in family planning in the region will also depend on cooperation between donors, as well as the positive political will of participating states. Given that most of the family planning program activities are focused in urban area and that city dwellers generally tend to use contraception more than rural dwellers, recent rises in contraceptive prevalence rates (CPR) at national levels are primarily due to exponential population growth in urban areas that were targeted by FHA. However, if reproductive behaviors in this sub-region generally follow patterns in the rest of the world over recent decades, the outlook for continued success over the next several years is excellent. Service and product use will rise in response to ever-higher levels of knowledge of methods, ever-lower infant/child mortality, and the diffusion of public health innovations and images of "modernity" from urban areas into the rural areas. The greatest single constraint will be the supply of commodities to meet escalating demand. The inability or unwillingness of host governments and non-governmental organization (NGOs) in the region to provide the necessary budgetary, logistic, product and service support in a reliable manner will weaken the CPR evolution launched by USAID and other donors. Addressing this issue effectively is the challenge that lies ahead.
Finally, the uncertainty of funding to combat the HIV/AIDS epidemic in the region is particularly acute for non-presence countries. USAID's assumption that other donors will finance some essential HIV program elements, such as condoms, is not always correct. For example, in Niger, condom supplies have been depleted for over a year. A recent UNFPA donation may not be adequate to deal with Niger's growing epidemic.
Possible Adjustments to Plan: None anticipated at this time.
Other Donors: The largest bilateral and multilateral donors working in the region are France, the World Bank, the European Union (EU), Germany, Belgium, the African Development Bank, Canada, and the United Nations agencies. These donors support construction, maintenance and operation of health centers and hospitals, and the procurement of essential drugs and other health commodities. Assistance is primarily focused on the public sector health system. Canada and the EU provide significant support for sexually transmitted diseases and HIV/AIDS prevention and mitigation. The Germans have been increasingly providing family planning commodities, especially condoms, in countries where USAID closed or reduced its activities. Overall development assistance to the health sector in the West African service delivery countries is approximately $75 million per year.
Principal Contractors, Grantees or Agencies: Activities are implemented through five U.S. private voluntary organizations (PVOs): Population Services International, Johns Hopkins University, Tulane University, the Johns Hopkins Program in International Education and Gynecology/Obstetrics (JHPIEGO), Family Health International (FHI) and ten African national and regional NGOs. The West African Health Organization, the health secretariat of ECOWAS, has recently requested assistance to develop a medium term strategic plan for its regional health interventions and is expected to be a key partner in implementing policy decisions in the region.
Selected Performance Measures: Selected performance measures exist for the FHA project and will continue to be reported on. At the same time, WARP is a new program with the first obligation planned in 2001. Therefore, appropriate baselines and targets are currently being developed.
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 897 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 8,195 DA 10,692 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 8,195 DA 11,589 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 7,875 DA 54,535 DA 70,605 DA 11,509 CSD 71,320 CSD 94,418 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
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Last Updated on: May 29, 2002 |
