[{"bbox": [123, 119, 457, 147], "category": "Section-header", "text": "## 3.4 Risks and Lessons Learnt"}, {"bbox": [75, 158, 1164, 1177], "category": "Table", "text": "<table><thead><tr><td>Category</td><td>Risks</td><td>Likelihood (High/ Medium/ Low)</td><td>Impact (High/ Medium/ Low)</td><td>Mitigating measures</td></tr></thead><tbody><tr><td>External environment</td><td>The political situation and the recurrent instability and crises could determine the suspension of the EU cooperation with Guinea-Bissau.</td><td>M</td><td>H</td><td>EU cooperation with Guinea-Bissau depends on a stable political, socio-economic and security context. It should be noted, however, that the international community remains engaged in a political dialogue with the authorities and that the situation is being closely monitored.</td></tr><tr><td>Planning, processes and systems</td><td>Institutional instability, resulting in high turnover of administrative staff, especially managers, in the line ministries</td><td>H</td><td>M</td><td>Establishment of an EU-government interface structure and a common consultation framework including other TFP, with a view to increase donor coordination and facilitate regular and coherent dialogue with national officials occupying strategic positions within the ministries.</td></tr><tr><td>People and the organisation</td><td>Low degree of ownership and participation of the national authorities (technicians) in the implementation of interventions</td><td>M</td><td>M</td><td>Establishment of an EU-government interface structure will help to continuously verify and foster ownership by the authorities, particularly in the formulation and implementation of EU interventions.</td></tr><tr><td>Environment and climate change</td><td>Increase of environmental hazards, shocks and stresses</td><td>M</td><td>H</td><td>Establishment of increased dialogue with national and international stakeholders to strengthen readiness, responsiveness and provision of essential services.</td></tr><tr><td>Legality and regularity aspects</td><td>Potential abuse of participation in conferences and seminars by inappropriate staff and to non-relevant events</td><td>L</td><td>L</td><td>EU will apply objective criteria for approving requests for funding, as well as adequate narrative and financial reporting on the use of the funds granted. This risk is also mitigated by the fact that the major part of the action will be under direct management.</td></tr></tbody></table>"}, {"bbox": [86, 1190, 246, 1214], "category": "Section-header", "text": "### Lessons Learnt:"}, {"bbox": [86, 1229, 1156, 1336], "category": "Text", "text": "Two components of the national health system (community health 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 through previous programmes, notably PIMI I and II, aimed at reducing maternal, newborn and infant mortality."}, {"bbox": [86, 1348, 1156, 1639], "category": "Text", "text": "Previous experience and recent evaluation findings show that PIMI I (2014-16) and II (2017-19) contributed at reducing maternal, newborn and infant mortality. Based on the latest data shared by WHO Africa, the country's rates of mortality decline are higher than the West African averages. Specific research commissioned by the EU in Guinea-Bissau shows 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). Yet, despite this remarkable progress, service coverage remains suboptimal. At the same time, perinatal mortality remains high at approximately 8% (before, during the first and second phase of PIMI). During the same period, mortality of women of fertile age declined, from 644 per 100,000 person in 2012-14 to 560 in 2014-16 and 565 in 2017-19. Despite overall progress, Guinea-Bissau must do much more to achieve the SDGs."}, {"bbox": [1043, 1689, 1160, 1713], "category": "Page-footer", "text": "Page 11 of 22"}]