Reproductive and family health
Title: TC module: Reproductive and family health in Guinea
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Co-funded by: European Union (EU)
Lead executing agency: Ministère de la Santé (Ministry of Health)
Overall term: 2015 to 2022
Years of political and economic instability followed by the Ebola epidemic of 2014 to 2016 have left the health system in Guinea in a weakened state. High maternal and child mortality has prevented the country from achieving its Millennium Development Goals. Health, especially that of women and girls, is affected by socio-cultural factors such as early marriage and female genital mutilation (FGM), which is still undergone by nearly all Guinean women. In 2016, less than nine per cent of women of childbearing age used a modern method of contraception. In rural areas, barely one third of births are attended by qualified personnel. Furthermore, human immunodeficiency virus (HIV) prevention is hampered by a shortage of counselling and testing services. Due to their poor quality, the rural population makes too little use of the health services provided, especially for reproductive health.
The use of health services, especially those for sexual and reproductive health, has increased in line with need.
The project promotes reproductive health in the regions of Labé, Mamou, Faranah and Kindia, and since August 2019 in N’Zérékoré with cofinancing from the European Union. GIZ works closely with the Ministry of Health and with other governmental and non-governmental partners. In addition to applying a systemic approach with targeted research and which involves ministries, institutions and communities, the project provides models for broader reforms to the health care system. Particular attention is paid to the gender dimension and the inclusion of people with disabilities. The project operates in five fields of action:
It strengthens the capacity of the Ministry of Health at the central level, in the areas of personnel administration, knowledge management and sector coordination, and supports the development of national strategies. It also supports digitalisation for the national health information system (NHIS) and the new Directorate of Human Resources (DRH).
The second field of action is aimed at strengthening health districts by developing operational action plans (OAPs) and implements an improved monitoring approach for the Ministry with scientific support.
In addition, the project improves the quality of services by providing training, equipment and supplies. This includes partographs, (graphic records of the progress of labour and relevant details of the mother and foetus) and a series of ‘micro projects’ to improve working conditions that the health care staff identify and manage themselves.
The fourth field of action entails strengthening community health and increasing the demand for universal access to nearby, high-quality health services. To this end, awareness-raising campaigns are implemented and a special emphasis is placed on young people’s access to youth-friendly services.
The project is also expanding an intersectoral approach towards FGM, in particular through dialogue forums that bring together religious leaders, political authorities, health workers, lawyers and media professionals on this issue.
By the end of the first phase, the use of reproductive health services has increased in the project’s regions. Couple years of contraceptive protection, i.e. the estimated protection provided by contraceptive methods during a one-year period, nearly tripled between 2015 and 2018, from 44,264 to 129,498, while outpatient attendance increased by six per cent. The number of births attended by qualified personnel rose significantly in at least two regions.
Simplified instruments and integrated OAPs have improved the Ministry’s strategic and financial planning, while modern software enables the NHIS and the DRH to make better use of their data. The partner coordination platforms have reduced overlap between interventions.
692 health professionals have been given training in obstetric and neonatal care. In 2018, 65 per cent of all health care facilities in the intervention regions used the partograph. Working conditions have improved for health staff thanks to the implementation of 35 micro projects.
Thanks to a public private partnership (PPP) with the firm SONOCO, 1,115 employees and their families have benefited from health care, health insurance and health education. Nearly 100,000 young people have been sensitised with regard to reproductive health issues, 15,000 have been tested for HIV and 17 dialogue forums on female genital mutilation have been successfully organised.