For more than five decades, poor performance of Guinea’s health and other critical sectors has crippled the well-being and growth of the country. Severely weak governance, at the central, regional and local levels, contributes to failures in the health sector as evidenced by the most recent 2014 Human Development Report that ranks Guinea among the ten lowest scoring countries worldwide. Under the guiding principles of the Global Health Initiative, USAID seeks to strengthen the health system for improved service delivery in close partnership with government institutions, NGOs and civil society to foster good governance, transparency and equity in the provision of health services. Guinea is a priority Presidential Malaria Initiative country and is focused on critical efforts that reduce maternal mortality, increase child survival and prevent and treat infectious diseases such as malaria and HIV/AIDS. USAID is focusing on increasing the ability of the Guinean health system and public to cope effectively with future outbreaks of Ebola and other health crises by building essential services back better, improving health planning and delivery and increasing public knowledge on key health issues and public confidence. Through the Health System Strengthening program, USAID seeks to maximize and sustain its longstanding and continuing investments in the health sector.
Malaria is the primary cause of consultations, hospitalizations and death in Guinea – it affects especially children under five years of age. In 2011, Guinea was included in the President’s Malaria Initiative, enabling USAID to scale up proven preventive and treatment interventions and to provide emergency supplies of life-saving medicines in response to nationwide stock-outs. USAID and partners in Guinea are not only procuring malaria commodities, they are also helping to strengthen health and pharmaceutical systems to properly store, distribute and use these commodities. They are building lab capacity, training health service providers and community volunteers and improving health seeking behaviors at the population level.
To date, Guinea conducted a nationwide universal coverage campaign in 2013-2014, distributing over 5.26 million Long Lasting Insecticide Nets (LLINs) of which 1.6 million came from PMI. Routine distribution of nets began in 2014 for pregnant women attending ANC and children under the age of one coming to health centers for Enlarged Program for Immunization (EPI). PMI procured 375,000 treatments and provided support for training and supervision of Ante Natal Care (ANC) workers in Intermittent Pregnant Treatment for pregnant women (IPTp) and for dissemination of communication messages for increasing knowledge and promoting prevention of Malaria in Pregnancy (MIP) at the community level. Training materials have also been updated in line with the new guidelines for IPTp.
PMI has purchased and distributed over 5 million Rapid Diagnostic Tests (RDTs) and purchased 48 microscopes and related supplies (reagents, gloves, disposal boxes and slides) and supported the development of an RDT utilization sheet that will help Community Health Workers (CHWs) track RDT use and better determine when they should request stock replenishment. PMI also supported training on quantification in the PMI target zones so that health facility personnel and regional warehouse managers understand the process and have the tools for calculating supply needs based on use.
PMI has provided Artemisinin-based Combination Therapy (ACT) treatments for all age groups in response to stock-outs in health facilities in both PMI and Global Fund zones, procured and distributed injectable quinine and injectable artesunate for the treatment of severe cases. PMI also developed a data collection form which allowed for a better quantification of needs at the facility level. Commodity distributions have served as an opportunity to introduce the new monthly malaria reporting template and process. Other key activities supported by PMI have included the introduction of a new medication (injectable artesunate) for the treatment of severe malaria and case management training of 1,329 health workers and CHWs.
PMI supported pharmaceutical system strengthening with the objective of reinforcing each of the critical functions of these entities (storage, distribution, logistic management information system and development and enforcement of policies and regulations).
PMI progress on Behavior Change Communication (BCC) to date has included revision of the NMCP’s national communication plan and training manual used by animators for BCC techniques related to malaria prevention and treatment. Case management training for health workers and CHWs has included a BCC component and CHWs are given job aid posters and story boards to conduct sensitization sessions on malaria prevention and treatment in their communities and over 200 000 people have been reached via home visits.
MATERNAL AND CHILD HEALTH
The maternal mortality rate of Guinea is one of the highest in the world. USAID aims to scale up evidence-based interventions and contribute to significant reductions in maternal, newborn and child morbidity and mortality. This includes access to quality integrated management of childhood services and fistula care activities encompassing prevention, surgical repairs and social reintegration. To improve quality of care and safety of the health environment USAID support introduction and scale up of infection prevention and control as well promoting best and safe practices in the current context of Ebola crisis.
FAMILY PLANNING AND REPRODUCTIVE HEALTH
Family planning uptake is still low in Guinea with a stagnant modern contraceptive prevalence rate. USAID aims to integrate family planning services with maternal and neonatal health, including emergency obstetric and newborn care. Emphasis is placed on quality improvement of health services in the area of family planning, maternity services and infection prevention, pre-service education by curricula harmonization within ECOWAS and enhancing the teaching skills of medical faculty and the national midwifery.
Last updated: June 08, 2016