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COUNTRY OVERVIEW
Political and Governance Context
The political and economic situation in Guinea has deteriorated over the last seven years, particularly after the incursion of Liberian rebels into Guinean territory in 2000/2001. All social, economic, and political indicators suggest a nation in decline. As a result of increased military expenditures, poor economic management and widespread corruption, the government has not properly serviced its external debt; it is experiencing high inflation (27% in 2004/2005), including spiraling prices for basic commodities; and it fails to deliver efficient, reliable public and social services to the Guinean people.
Political power is divided along ethnic lines. However Guinea’s various ethnic groups (the Sousou of Maritime Guinea, the Peuhl of Middle Guinea, the Malinke of Upper Guinea region and a mix of smaller ethnic groups in Forest Guinea) generally maintain peaceful relations with one another outside the political arena.
Surveys of media independence by Freedom House and of press freedoms by Reporters Without Frontiers consistently rate Guinea as not free. Guinea has one government owned radio and television station--Radio and Television of Guinea (RTG). Although the President signed the Decree authorizing private radio and television in August 2005, as of July 2006 the GoG has only granted three licenses for independent radio stations and none for television.
Health Context
Deterioration of key social and public services has reached alarming proportions in most of the country and the consequences can be seen in worsening mortality and malnutrition rates. Health care, education, water supply, and telephone and electrical services each have eroded substantially over the past decade.
Although progress was made in the 1990s on health indicators in Guinea, the 2005 Demographic and Health Survey (DHS) shows stagnation and even reversals since 1999, despite the efforts of USAID and other donors. Environmental sanitation is poor and cholera and typhoid epidemics occur regularly. Diarrheal disease and malaria, complicated by malnutrition, are the leading causes of death among children 0-5 years of age. Infant mortality is 163/1000. Over 60% of births are not attended by a trained health care provider. Maternal mortality, which was 528 in 1999, has jumped to 847 per 100,000 live births. This figure reflects an overall increase in adult mortality and is also attributable to the failure of the health system to provide adequate prenatal and emergency obstetrical care, coupled with poor nutritional status of women in their reproductive years. Thirty-five percent of the population is stunted from chronic malnutrition. Over half of primary school pupils suffer from malnutrition and heavy parasite loads affecting their academic potential. Seventy-seven percent of children 6-59 months of age are afflicted by chronic anemia. Vaccine shortages in the national pharmacy, a poor drug and vaccine distribution system and a weak national outreach program for immunization services have caused set backs to Guinea’s immunization program. There are significant social and economic barriers limiting woman’s access to family planning. Childhood marriage and high rates of female genital cutting remain a challenge.
While the 2005 DHS reported a relatively low rate of HIV/AIDS of 1.5% among the general population, empirical evidence within the health care system is indicative of the significantly greater rates among high-risk groups: commercial sex workers (42.3%), transportation workers (7.3%), miners (6.6%) and youth (2.5%). Guinean women continue to be more affected by the virus than men with an HIV rate of 1.9% versus 0.9% respectively. Antiretroviral drugs (ARV) and drugs to prevent mother-to-child-transmission are scarce.
A slight increase in contraceptive prevalence is evident in USAID’s impact zone; however the national modern contraceptive prevalence rate is a mere 5.7%. The 2005 Demographic Health Survey indicated that there was a significant unmet demand among couples for child spacing and family planning services. Low levels of education for women combined with early marriage continue to be barriers to expanding couple years of protection.
Education Context
Despite major challenges facing the education system, Guinea continues to be very successful at increasing demand for and access to primary education. The percentage of school-aged children attending primary school is steadily increasing. Over the last three academic years (2002/2003, 2003/2004, and 2004/2005) it jumped from 74% to 77% to 79%. The percentage of girls enrolled in school is also consistently rising. It increased from 67% to 70% to 73%. The percentage of rural children attending primary school increased from 55% to 58% to 61%. Admission rates at the Grade 1 level and retention rates until Grade 6 both demonstrate positive gains. Although access to primary education has improved markedly during the past 10 years, serious shortfalls remain in children’s primary cycle completion and persistence. Only 42% of children complete primary school. The average class size in Guinean primary schools increased from 55 during the 2000/01 school year to 60 in 2004/2005 and, despite important USAID contributions, there continues to be a substantial lack of teaching and learning materials.
Agriculture and Natural Resource Management Context
Guinea has a rich endowment of natural resources, including abundant deposits of bauxite (one-third of global proven reserves), gold, diamonds, offshore oil, and an estimated 1.8 billion metric tons of high-grade iron ore. Underexploited fishing and agriculture sectors have considerable potential. Every major West African river begins in Guinea, giving the country the title of “The Water Tower of West Africa.” The watersheds contained in Guinean borders are critical to the stable flow of water to six other West African countries. Soils are capable of sustaining the country’s population and quite possibly generating a surplus for interregional or international trade. Despite these advantages, Guinea has confronted consistent poverty in its nearly half century of independence. Many families today live in impoverished circumstances, and public services are not provided at a level commensurate with Guinea’s natural wealth. In 2005 it was estimated that 53% of the population was living below the poverty line, compared with 40.3% in 1994/95. Per capita gross national income declined from $450 in 2000 to $386 in 2004.
From 1997 to 2005, CCP partnered with Management Sciences for Health (MSH) and, in the last two years of the project, EngenderHealth, to implement USAID’s health program through the project Pour Renforcer les Interventions en Santé reproductive et MST/SIDA (PRISM--Strengthening Interventions in Reproductive Health and STD/AIDS). The purpose of PRISM was to increase use of essential family planning/maternal child health and sexually transmitted infection prevention services and practices. The program had four major Intermediate Results: 1) Increased access to reproductive health services; 2) improved quality of reproductive health services; 3) increased demand for reproductive health services; and 4) improved co-ordination of reproductive health interventions. The project covered the regions of Upper Guinea and Forest Guinea.
Throughout the program, CCP was responsible for the design, implementation, monitoring and evaluation of IR3: increased demand for RH services. The overall goal of the demand generation component was to increase demand of information and use of MCH/FP and STI/HIV/AIDS services.
ACTIVE PROGRAMS
A Plusieurs Faisons Ensemble (As Many, Let Us Act Together)-- Multi-Sectoral Interventions to Advance Democratic Governance in Guinea. This program, led by RTI International in partnership with:
- African Center for Training and Development (CENAFOD)
- Enterprise Works/Volunteers in Technical Assistance (EWV)
- Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP)
- Mano River Women’s Peace Network (MARWOPNET)
- Population Services International (PSI) and
- World Education, Inc. (WEI)
Starts up in May 2007 in the regions of Upper and Forest Guinea and Greater Conakry, with offices in Conakry, Dabola, Kankan and N’Zérékoré. The project was designed to meet the challenge posed by USAID/Guinea’s 2006-2008 country strategy to use the one Strategic Objective of governance reform to achieve impact in the sectors of democracy and governance, health, education, and agriculture and Natural Resource Management (NRM). The vision of A Plusieurs Faisons Ensemble is that by improving governance in health, education, and the agriculture and natural resource management sectors, the population will have improved services and will be more empowered. The Faisons Ensemble consortium will implement this vision through five strategies:
- Integration of practice across sectors
- Building on indigenous models,
- Working with and through Guinean partners
- Developing a vanguard of good governance champions, and
- Pushing-pulling change with interventions aimed at the intersections of USAID and Guinea citizens’ priorities.
CCP’s role will focus on strategic objective 4 of USAID/Guinea’s new strategy: Increased citizen access to more diverse sources and types of information. CCP will contribute to:
- Increasing Guineans’ access to diverse sources of information by advocating for a more open media environment and by improving the media infrastructure and media skills through intensive capacity building.
- Increasing Guineans’ access to more diverse types of information by designing multi-media communication interventions to improve their knowledge of their rights and responsibilities as citizens and by strengthening Guineans’ capacity to get truly involved and take action in democracy and governance for health, education, and natural resources management through effective communication tools and materials.
PAST PROGRAMS
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