[{"bbox": [90, 121, 1150, 199], "category": "Text", "text": "access to youth-friendly reproductive health services. This additionally hampers the productivity and well-being of young people across the country. Poverty also impacts women more than men, reflecting gender inequalities in access to land, credit, education and health."}, {"bbox": [90, 213, 1150, 425], "category": "Text", "text": "Despite remarkable progress over the past decades, Guinea-Bissau still figures among the countries of the world which bear the highest burden of maternal and child mortality, and reproductive health is not effectively addressed by public policies. The country's maternal mortality ratio was estimated at 667 deaths per 100,000 live births in 2017 and its neonatal mortality rate at 35.1 per 1,000 live births in 2019, which are among the highest rates globally. Concerted action is thus needed to approach the related SDG targets by 2030, i.e. a reduction of maternal mortality to below 70 per 100,000 live births (SDG 3.1) and neonatal mortality to below 12 per 1,000 live births (SDG 3.2). Universal access to quality routine and emergency Maternal and Child Health (MCH) services is considered essential to improve maternal-perinatal health and survival chances of mothers and newborns."}, {"bbox": [90, 437, 1150, 544], "category": "Text", "text": "The previous EU funded programmes, PIMI I and II, contribute to a reduction in maternal and infant mortality through better access to quality maternal and child healthcare services in Guinea Bissau. However, further actions are needed to ensure better coverage of primary health care. This requires stronger cooperation among main health stakeholders to actively participate in the (re-)design and implementation of country-led policies and strategic plans."}, {"bbox": [90, 556, 1150, 609], "category": "Text", "text": "From a more general viewpoint, Guinea-Bissau will continue to depend on strong support by the international community, due to chronicle lack of budgetary resources and insufficient administrative capacity."}, {"bbox": [90, 621, 1150, 699], "category": "Text", "text": "The participation and representation of some actors, such as civil society, health experts and marginalised groups, are insufficient in decision-making processes. There is limited transparency which makes it difficult to hold actors accountable for their actions."}, {"bbox": [90, 714, 1150, 794], "category": "Text", "text": "The priority areas and activities identified for this programme will contribute to enhance health and nutrition of women in reproductive age, newborns and children under five in Guinea-Bissau. These are preconditions for wellbeing, improved living standards and progress in human development."}, {"bbox": [90, 819, 1150, 873], "category": "Section-header", "text": "### Identification of main stakeholders and corresponding institutional and/or organisational issues (mandates, potential roles, and capacities) to be covered by the action:"}, {"bbox": [90, 884, 1150, 1017], "category": "List-item", "text": "- National authorities, specifically public administration in the various ministries and other national institutions should be involved in both identification and formulation phases and in the action's implementation. These include, in particular: Ministry of Health and Ministry of Finance, Ministry of Women, Family and Social Solidarity, Regional Health Directorates, National Health Institute⁵, the National School of Nursing and the Health structures."}, {"bbox": [90, 1033, 1150, 1166], "category": "List-item", "text": "- Private non-profit health providers, given their role as partners in providing good quality care in the country (Caritas, Bor Hospital, Cumura Hospital, Fondazione Renato Grandi, Centro Sanitario Caterina Troiani, etc.). They will be involved in policy dialogue and exchange platforms that will lead to policy reforms. Moreover, these structures, which often operate with high quality standards, can be integrated and can be scaled up to maximise cost efficiency, financial sustainability and help solving the accessibility problem."}, {"bbox": [90, 1178, 1150, 1363], "category": "List-item", "text": "- Civil society actors, considering their key role in enhancing the right to health, as well as religious and traditional leaders. The action will operate in close cooperation with the Liga Guineense dos Direitos Humanos and with women's associations, such as “Plataforma política das mulheres” (women's civil society organisation (CSO) for Empowerment, Gender Equality and Political Participation), RENLUV (network of organisations that fight gender inequalities and child-based violence in Guinea-Bissau), and Miguilam (movement for women's empowerment). Also CSOs representing rights of persons with disabilities and minorities will be involved in the implementation of the action."}, {"bbox": [90, 1376, 1150, 1561], "category": "List-item", "text": "- Other technical and financial development partners, notably those implementing EU interventions, such as the United Nations system and EU Member States' agencies. Various Technical and Financial Partners (TFPs) are involved in the implementation of specific health programmes financed by the EU, notably the World Bank, the Global Fund, the World Health Organisation (WHO), the United Nations Development Programme (UNDP) and EU Member State agencies such as the Camões Institute (Portuguese cooperation) within the *Ianda Guiné Saúde* programme. However, with the exception of a WHO chaired mechanism on Covid-19 with the main health donors, there is no formal, effective, efficient and regular aid coordination mechanism that brings together all the"}, {"bbox": [80, 1600, 1160, 1644], "category": "Footnote", "text": "⁴ Maternal mortality ratio (modelled estimate, per 100,000 live births) - Guinea-Bissau, WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Trends in Maternal Mortality: 2000 to 2017. Geneva, World Health Organization, 2019."}, {"bbox": [80, 1644, 437, 1664], "category": "Footnote", "text": "⁵ Instituto Nacional de Saúde Pública (INASA)."}, {"bbox": [1055, 1690, 1160, 1714], "category": "Page-footer", "text": "Page 5 of 22"}]