[{"bbox": [81, 146, 1167, 924], "category": "Table", "text": "<table><tr><td rowspan=\"3\">People &amp; organisation</td><td>7. Insufficiently qualified human resources within Ministry of Health hinder the improvement of health services</td><td>High</td><td>High</td><td>Efficient recruitment will be encouraged and supported, as well as retention practices and corporate culture. Technical assistance and peer learning should help strengthen the technical and administrative team, increasing their motivation.</td></tr><tr><td>8. Resistance by Health staff to adopt more modern practices and protocols, including supervision (ethics).</td><td>Low</td><td>Medium</td><td>Prioritization of demonstrative activities based on successful experiences, as well as practices being developed based on the recognition of the importance of innovative techniques, protocols and procedures. Support the development and implementation of ethical standards of behaviour, including ethical clinical, leadership, management, research and quality-improvement practices.</td></tr><tr><td>9. Resistance of target groups in participating in the implementation of the Action</td><td>Low</td><td>High</td><td>Intervention methodologies based on participatory mechanisms and prioritizing activities that can bring benefits in the short term and that can increase the level of confidence in the Action.</td></tr><tr><td>Legal &amp; regulatory</td><td>10. Implementation of the project may require legal and regulatory changes in the Health sector</td><td>Medium</td><td>Medium</td><td>An initial diagnostic identifying gaps, bottlenecks and challenges for a policy and regulatory framework more conducive for changes in the health administration and management of Human Resources. Availability of technical assistance to support the relevant authorities to address them. Strengthened policy dialogue and advocacy.</td></tr></table>"}, {"bbox": [92, 938, 253, 962], "category": "Section-header", "text": "## Lessons Learnt:"}, {"bbox": [92, 978, 1161, 1149], "category": "Text", "text": "In the last 10 years, two components of the national health system (treatment of the main infectious diseases - HIV, tuberculosis and malaria, and maternal and child health) have been able to maintain a minimum access to quality services for the most vulnerable population, contributing to a significant improvement in certain public health indicators. Both of these components have received substantial support from the EU. In particular, maternal and child health has been addressed for more than a decade through PIMI programme, aimed at reducing maternal, new-born and infant mortality."}, {"bbox": [92, 1163, 1161, 1391], "category": "Text", "text": "Based on the latest data shared by WHO Africa, the country's rates of mortality decline are higher than the West African averages, and the evaluations of EU-funded programmes PIMI I and II showed impressive increases in the uptake of essential MCH services over time. For example, the overall proportion of women having obtained four or more antenatal care (ANC) visits increased markedly from 32% in 2013 before the introduction of the programme to 45% in the first phase of PIMI (2014-16) and 56% in the second phase (2017-19). Likewise, the proportion of facility births increased markedly from 33% (2013) to 39% (2014-16) and 49% (2017-19). The EU intervention has furthermore resulted in a good balance between the increase of demand for services and improvement of quality, and in the valid key prioritisation of standards and protocols by Ministry of Health."}, {"bbox": [92, 1404, 1161, 1488], "category": "Text", "text": "Yet, despite this remarkable progress, which the government is unable to maintain in the absence of external aid, service coverage remains suboptimal and Guinea-Bissau must do much more to achieve the SDGs and reduce malnutrition, which remains one of the main underlying causes of infant mortality in Guinea Bissau."}, {"bbox": [92, 1502, 1161, 1617], "category": "Text", "text": "The Ministry of Health fully recognizes the role of the EU in the financial, logistical and methodological support to maternal and child health, as well as in health governance, thanks to the support provided in drafting the National Development Health Plan 2023-2028 (PNDS) and the National Development Plan for Health Human Resources 2023-2032 (PNDRHS) through the project Ianda Guiné Saúde (2019-2023). The process of drafting the two documents"}, {"bbox": [1022, 1679, 1142, 1704], "category": "Page-footer", "text": "Page 15 of 26"}]