Republic of Guinea-Bissau Poverty Assessment and Social ...

Report No. 13155-GUB

Republic of Guinea-BissauPoverty Assessment and Social SectorsStrategy Review(In Three Volumes) Volume III Annexes

June 3, 1994

Africa RegionSahel DepartmentCountry OperationsFOR OFFICIAL USE ONLY

Document of the World Bank

This document has a restricted distribution and may be used by recipientsonly in the performance of their official duties. Its contents may not otherwisebe disclosed without World Bank authorization

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CURRENCY EOUIVALFNTS

USSI 00 - 12.296 Guinean Pesos

(June 1994)

ABBREViATIONS AND ACRONYMS

AIDB African Development BankAGBEPSF Associacao da Guine-Bissau pars Educacao e Promocao da Saude Famniliar

(IPPF Affiliate in Guinea-Bissau)AIDS/SIDA Acquired Immune Dericiency SyndromeASB Basic Communiry Health AgentASDI Swedish international Development AuthorityCDR Crude Death RateCECI Canadian Center for Studies and otgrnational CooperationCECOMES Center of Communication and Production of Education Materias for HealthCEEF Center for Educational and Training ExperimentationCEFAG Agricultural Experimental Training CenterCEFC Rural Development Training CenterCENFA Administrative Training CenterCENFI Industrial Training CenterCERPOD Centre d'Etudes at de Recherche sur la Populaidon pour It Developpement

(Regional Population Research Organization. Bamako. Mali)CIDAC Informtation and Documentation CenDIr AmWicar CabralCRAC Center for Busineas Retaiding and ImprovemenDANtDA Danish laternstional Development AgeDncDESEP Departmernt of Staistics and Planning ServicesDGAF Genera Directorate of Administtion and FinancingDGPP General Directorate of Planning and ProjectsDGSP Geneal Public Health DirectoratDHS Demogrpbic and Heith SurveyDIS Drug Information SystemDRE Regional Education DepartmentEDP Esse-ia Drug ProgramEC European CommunityFAi Fondo di Aiuai Indiana (Italian Aid Fund)FAO Food and Agriculture Organization of the United NationsFARMEDI Nation Pharmaceutical Procurement OrganizationFP Family PlnnmingHC Health CenterGDP Gross Domestic ProductGNP Gross NatiOnDa ProductHIS Health Information System (also combined with MiS)IDA nternational Development ASSociation[EC information, Education and CommuicationIMvF IternaDtiona Moetary Fund[MR Infant Mortality RateINAFOR National Inst. of Technical and Vocational TraininSINDE Nationai Institute for Educational DeveLopmentIPPF International Planned Paremthood FederationMCH Maternia and Chiid HealthMtNPH Minstry of Public HealtbMIS Management Information System (also combined with HIS)MMR Maternal Mortality RaeMiNNE Ministry of National EducationNATCAP National and Technical Cooperation Assessment ProgranNGO Noni-Governmental OrganizationOiT Organisaxion Internationale du TravailORT Oral Rehydration TherapyOXFAM Oxford Committee for Famine ReliefPAM/WFP World Food ProgramePAVIEPI Expanded Program of ImmunizationPCHHE Per Capita Household ExpenditurePEM Protein-Energy MalnutritionPG GuineaD PesoPHC Primary Health CarePHCW Primary Health Care WorkerPHN Population. Healtb aud NutritionRADDA BARNEN Swedisb Ssve the Cbl4dran Organization (NGO)SAC Strucural Adjusstment CreditSAP Structral Adjustment ProgramSAREC Swedish Agency for Research CooperadiOn witb Developing CountriesSIRW Social and Infraamuctar ReiAef ProjetaSNV Dutcb Coopeantio for Techmncal and Social AssixtancSOIuDAMMi Solida rit ad Friendship isttlntioaSSPH Secreary of Sates for Public HealthSTD Sexually Tranmitted DiseasrTA Technicai AsigtnUDEMU Demcnradc Union of WomenUNDP United Nadons Developmam PrTOgrtm.-UNESCO UN Educationo Scienti1c and Cuarl OrganizatioUNFPA Unitd Ntions Fund for Popululon AcivitiesUNICEF Unied Natons Cbildrns PFundUNiPAC UNICEF Pturmam ca Prcurmmt AgecyUSAID Unitke Stte Agncy for iternaonal DevlopmUSB Baic Heatb Uit or PoetWHO World Health Organizaion

FRCALI YFAI

January I - December 31

FOR OFFICIAL USE ONLY

GUINEA-BISSAU

POVERTY ASSESSMENT AND SOCIAL SECTORS STRATEGY REVIEW

LIST OF ANNEXES. TABLES AND FIGURES

VOLUME m

CHAPTER I - HEALTH AND POPULATION

ANNEX I-1 Health FacilitiesANNEX 1-2 Management ConstraintsANNEX 1-3 Hospital Sub-Sector

Table I Health Facilities and Beds by Facility CategoryTable 2 Hospital Beds by Specialty (1989)Table 3 Activities at Hospital in Guinea-Bissau, 1988/89Table 4 Health Personnel in Hospitals of Guinea-Bissau, January 1989Table 5 Targets for Number of Health Personnel (in National Health Plan)Table 6 Difference Between Target and Actual Number of Personnel (1989)Table 7 Health Personnel by Region (1987/88)Table 8 Salaries for Health Personnel in PG (estimates October 1990)Table 9 Selected Items from Price List for Medical Services (Valid from

November 1, 1990, in PG)Table 10 Division of Labor Between the National Hospitals (Number of Beds,

1989)Table 11 Distribution of Beds at Simao Mendes Hospital (1990)Table 12 Nationalities of MDs at Simao Mendes Hospital (October 1990)Table 13 Distribution of Hospital Services by Region (1989)

Figure 1 Organizational Chart - Simao Mendes Hospital (1990)

ANNEX 1-4 International and Donor Organizations Involved in the Health SectorANNEX 1-5 The Health sector - Tables and Figures

Table I Matrnal Mortality Rate Per 1,000 Live Births Per RegionsTable 2 Car Accidents and Victims, 1989-89Table 3 PHC-Pr.-Natal, Births and Consultations in USBs in 1989Table 4 Primary Health Care Evolution and Potential PHCW Coverage Over

10 yeasTable 5 PHC-Disease Consultations Held by ASBs un USBs, 1989Table 6 - Health Centers-Existing and Intended Human Resources, 1989Table 7 HC Attendmenxs (Real Coverage), 1989

Figure 1 Reported Cases of Diarrhea in Guinea-BissauFigure 2 Reported Cases of Measles in Guinea-BissauFigure 3 Birth AssistanceFigure 4 Place of BirthFigure 5 Water at HomeFigure 6 Ministry of Health - Partial Organization Plan (Nov. 1990)

ANNEX 1-6 Health and Management Information System (HIS/MIS)

This document has a restricted distribution and may be used by recipients only in the performance of thelrofficial duties. Its contents may not otherwise be disclosed without World Bank authorization.

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CHAPTER II - EDUCATION AND TRAINING

ANNEX lI-1 Language of InstructionANNEX [1-2 Situation of the Primary School TeachersANNEX 1I-3 Technical and Vocational EducationANNEX 1I-4 The Use of Television in EducationANNEX fl-5 International and Donor Organizations Involved in the Education SectorA NNEX nI-6 The Education System - Tables and figures

Table I Primary Education, Grades 14. School-Age Population 7-10,Enrollment Rates

Table 2 Primary Education, Grades 1-4. School-Age Population 7-12,Enrollment Rates/Gender

Table 3 Primary Education, Grades 1-6. School-Age Population 7-12,Gross Enrollment Rates

Table 4 Primary Education, Grades 1-6. Female Share of Enrollment byGradelRegion

Table 5 A-B Primary Education, Grades 1-6. Internal Efficiency Indicators:Repetition, Drop-out and Retention Rates by Grades/Gender. (1988/89and 1990/91).

Table 6 A-B Primary Education, Grades 1-6. Student/School and Student/TeacherRatios by Region.(1988/89 and 1992/93).

Table 7 Primary Education, Grades 1-6. Distribution of Teachers byRegion/Gender

Table 8 Pre-School and Primary Education, Grades 1-6. Number of Teachersby Salary Scale (1992).

Table 9 Private contribution. Share in Education FinancingTable 10 Secondary Education. School-Age Population 13-17, Gross

Enrollment Rates (1981/82 - 1996/97).Table 11 Basic Secondary Education. Female Share of Enrollment by

Region/Grade (1990/91).Table 12 Basic Secondary Education. Internal Efficiency Indicators: Repetition,

Dropout, and Retention Rates by Grade/Gender (1990/91).Table 13 Basic Secondary Education. Teachers by Education Level (1990/91-

1992/93).Table 14 Basic Secondary Education. Distribution of Teachers by

Region/Gender (1990/91-1992/93).Table 15 Unit Cost by Level of Education (1988/89).Table 16 CENFI Enrollment Courses (1990/91-1992/93).Table 17 CENFA Enrollment (1988/89-1992/93).Table 1 - CEFC and CEFAG Enrollment (1988/89- 1992/93).Table 19 Allocation of Education Operating Budget/Levels of Education (1980-

1989).

Figure 1 Organigram of the Ministry of Education and Culture (1993).Figure 2 Primary School, 1992-93. Female/Male Enrollment, Ages 7-12,

Grades 1-6Figure 3 Primary School, 1992-93. Distribution of Teachers by Gender and

RegionFigure 4 Secondary School, 1992-93. Female/Male Enrollment, Ages 13-17,

Grades 7-11Figure 5 Secondary School, 1992-93. Distribution of Teachers by Gender and

RegionFigure 6 Structure of the Education System in Guinea-Bissau (1990)

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THE STATUS OF WOMEN IN GUINEAN SOCIETY

ANNEX I-1 Women's Status and Role in Guinean SocietyANNEX m-2 Institutional Framework for Women's AffairsANNEX M-3 Lodal Consultants' ReportsANNEX 11-4 Profiles of Non-Governmental Organizations

QUALITATIVE POVERTY ASSESSMENT

ANNEX IV-I Current Perception of Poverty

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ANEX I - IPage 1 of 3

GUINEA-BISSAU

HEALTH FACILMTIES

The distribution of health facilities by level and by region in Guinea-Bissau appearsbelow. The population for each region is for 1992 and comes from the Ministry of PublicHealth. Data for the USBs is for 1993.

BISSAU SECTOR (Includes urban area and Bairros)

Population: 207,609 (1 sector)

2 National Hospitals- Hospital Nacional 3 de Agosto- Hospital Nacional Simao Mendes

1 Mental Health Center1 Rehabilitation and Motor Function Disorder Center1 SMI/PF National Reference Center7 Peripheral Health Centers (Centros Perifericos)1 Basic Health Units (USB)

BAFATA REGION

Population: 147,564 (6 sectors)

1 Regional Hospital1 Sectoral Hospital

12 Health Centers (HCs)123 Basic Health Units (USBs)

BIOMBO REGION -

Population 60,830 (3 sectors)

1 Leprosy Hospital1 Sectoral Hospital7 Health Centers (HCs)0 Basic Health Units (USBs)

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ANNEXI-IPage 2 of 3

BOLAMA/BUAGOS REGION


1 Regional Hospital1 Sectoral Hospital16 Health Centers (HCs)65 Basic Health Units (USBs)

CACHEU REGION


1 Regional HospitalI Sectoral Hospital14 Health Centers (HCs)172 Basic Health Units (USBs)

GABU REGION


1 Regional Hospital1 SMI/PF Reference Centeri Sectoral Hospital18 Health Centers (HCs)140 Basic Health Units (USBs)

OIO REGION


2 Sectoral Hospitals13 Health Centers (HCs)169 Basic Health Units (USBs)

QUINARA REGION


3 Sectoral Hospital12 Health Centers (HCs)49 Basic Health Units (USBs)

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ANNEXI-1Page 3 of 3

TOMBALI REGION

Population: 73,896 (4 swetors)

3 Sectoral Hospitals22 Health Centers (HCs)118 Basic Health Units (USBs)

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ANNEX I -2Page 1 of 4

GUINEA- BISSAU

MANAGEMENT CONSTRAINTS

General Management

1. MINPH has few senior staff that have any formal training in management. In the past,most Director and Division Chief level personnel appear to have been appointed to their positionsfor internal political purposes rather than for their skills as managers. This has resulted in acollectivity of technically trained staff (e.g., in medicine or nursing) who "administer" ongoingactivities in an inconsistent manner. MINPH's hierarchy is structured on authority levels that arenot necessarily based on skills or competence of the incumbents. The "power" associated with aparticular position often emanates from the incumbent's social/political- status (e.g., personal orfamily role related to participation in the 1975 War of Independence, a family relationship to ahigh-level government official in other Ministry, or by titles earned through professionaleducation obtained abroad (e.g., doctoral and other advanced degrees).

2. At the functional level, decisions are highly centralized and little attention has been givento administrative succession. This has been particularly problematic in regards to the delegation ofauthority to subordinates. Many mid-level MINPH professional staff have no clearly definedmanagerial roles and appear to function as "assistants" and junior level staff even though theirtitles indicate a higher level of authority. However, this phenomena is not considered to be uniqueand occurs throughout much of Guinea-Bissau's public sector. In the past, a senior MINPH staffmember could be absent from the country for prolonged periods of time and little was done toname a subordinate who could " act' in their behalf during their absence. It is also commonknowledge that external (international) travel provides the opportunity to earn additional incomethrough per diem and other foreign travel allowances. It must be noted that, unlike the previousMinister of Public Health, the present Minister has the advantage of an effective deputy (SSPH)who has the authority to function effectively as acting Minister during her absence.

3. In discussions with several of the senior MINPH staff it was noted that many of themhave particular interest in taking basic management courses. While many expressed an interest intaking management courses outside the country, all agreed that some steps should be taken toarrange for intense, short (2-3 week) courses to be given in Bissau. When asked about thecontent that would be particularly needed, most indicated that they would like to learn "how to"types of management approaches that include personnel management, organization, planning andthe use of personal computers and management information systems. At present, there are noexisting opportunities for MINPH's senior level staff to improve their management skills throughformal training. Given these factors, it is evident that future Bank funded project activities shouldaddress this expressed need for management training.

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ANNEX I - 2Page 2 of 4

Administrative/Office Systems

4. MINPH's administrative and office systems are considered to be inefficient andunderdeveloped. While some secretarial staff use electric typewriters, most use manualtypewriters for routine correspondence and report preparation. The use of word processingthrough personal computers (PCs) has not been used in the central MINPH facility, despite thefact that a system has been purchased and installed through the PHN project. There has been aninterest expressed by many of the secretarial and clerical staff to learn how to use the PC andword processing. However, since no senior management staff have endorsed the use of PCs,little has been done to begin training the secretaries or to introduce word processing.

5. Despite some MINPH environrental concerns (e.g., power outages, heat and dust) manyorganizations in Guinea-Bissau (e.g., WHO, UNDP and Radda Barnen) have been able to usePCs effectively in their daily administrative and office operations. At present, the main obstaclesto the introduction of modem word processing in MINPH is a lack of management commitment,availability of additional PCs, and training of secretarial/administrativestaff.

6. Other administrative and office systems (e.g., filing and document preparation, retrieval,accounting), are likewise labor-intensive activities. Little automation is available to effectivelyprocess payments and store data. Routine preventive maintenance and servicing of someequipment such as copying machines, is limited or non-existent; as a result, needed copies are ofa poor quality or simply do not get made. Other equipment such as manual typewriters,mimeograph machines, adding machines and calculators, often lack the supplies and parts neededto function. In terms of basic efficiency of the current administrative system, more attentionshould be given to the availability and operation of office equipment.

7. Other MINPH administrative resources appear to be at their maximum in terms of theirproductive capability. The physical office space is small and there is not an effective use ofspace. However, recent efforts to renovate the MINPH central office facility may result in amore efficient use of existing space. In general, files and records are not efficiently stored. Manyare kept stacked on desks, on shelves or in boxes. In one operating division MCH/FP, clinic datathat is three to four years old is kept on open shelves. The document filing system is accessibleto anyone, even confidential records.

Planning and Evaluation

8. MINPH engages in two basic types of planning activities: (a) those required for annualreporting and budgetary planning, and (b) those related to projects supported by internationaldonor organizations such as UNFPA, DANIDA, Radda Barnen and the World Bank. While thereis a five-year strategic plan, most planning appears to be operationally focused and is reactiverather than pro-active. Several MINPH Directors have indicated that they would like continuedtechnical assistance to strengthen the planning process. While SSPH will have direct oversight ofthe MINPH planning activity, there appears to be only a few staff who have planning skills.Prior to arrival of the current Minister of Public Health, MINPH had only cursory involvement

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with resources at the Ministry of Planning. It is important that MINPH continue to strengthen itsown planning capabilities, as well as work more effectively with the Ministry of Planning.

9. MINPH has implied goals of improving Guinea-Bissau's health indicators (e.g., the highinfant and maternal mortality rates). These goals must be linked with other development targetsand be included in MCH/FP's strategic and operational planning. In the case of MCH/FP,demographic and health targets should be linked to family planning program objectives. Datafrom the Inguerito Demografico e Sanitario (DHS) and available MCHIFP service statistics (ifthey were complete) could be used to assist MINPH in planning and in developing policyobjectives.

10. Effective planning is hampered by a lack of precise information on the physical equipmentand other aspects of the existing infrastructure, and by a scarcity of reliable data to calculateservice delivery coverage rates and program effectiveness. The current MINPH reporting formsgive only numbers of consultations rather indicators pertaining to the persons attended. Thisinformation should be collected and be made available to planners on a regular basis. In addition,it is imperative that there be a strengthening of the MIS that includes infrastructure, personnel,training status, equipment, supplies, and output (service statistics) as this information is requiredto assist program management in the planning process.

11. Since 1975 there has been a gradual evolution of NINPH program activities that has ledto an increased awareness of the need for timely and accurate health data and information.Information needed to measure the growth of most of MINPH's programs or their impact onhealth indicators is limited. Most data emanate from the service statistics system, which eitherover or under reports data. Compliance with recording information may not be uniformlyadhered to throughout Guinea-Bissau's health system. Hospital records, which supply much ofthe data on mortality HIV infections, STDs, etc., also lack precision due to incompleteness.

Supervision and Controls

12. While staff supervision appears to be adequate for MINPH staff in Bissau, it is notconsidered to adequate for regional and field operations. The main reason for this is thelimitations in available supervisory personnel, transportation and fuel. Typically, there have beentwo types of supervision: one involves MINPH central (Bissau) staff going to the regionsperiodically, and the other involves the regions' own operational supervision. The visits fromBissau to the regions are usually on an 'as needed basis" (usually quarterly) and involve one ormore senior MINPH staff. Because the regions have a strong say in their particular servicedelivery programs, the Regional Medical Director and/or Chief Regional Nurse, join MINPHBissau staff during the visits. Supervisory visits are usually announced in advance and 'surprise"visits from Bissau have never been a common practice. A review of staff and logistical needs isusually included in each supervisory visit. The visits have to be coordinated with the rainy seasonbecause access to some remote areas can be difficult.

13. Operational supervision within the regions is severely hampered by the lack of availabletransportation. Staff from regional and sectoral hospitals have difficulty going to the healthcenters for routine supervision of staff because they lack the means to get there. Vehicles are

ANNEX I -Page 4 of 4

usually not in service or non-existent. In some areas, routine program supervision (e.g.,MCH/FP) is done on foot or by light motorcycle or bicycle (where available). Consequently,supervision, which is vital to maintaining program quality, is incomplete.

14. Other supervision and control takes place by communication between MlNPH-Bissau andother locations. There are four ways in which MINPH management communicates with theregions: (a) occasional telephone communication between Bissau and the regions; (b) periodicMINPH meetings in Bissau, which are attended by regional staff and afford opportunities fordiscussing program maters; (c) correspondence sent through messengers and MINPH stafftraveling to and from the regions; and (d) regularly scheduled supervision visits from Bissau tothe regions. A general lack of functioning telephones affects the communication with MINPH ofmany of the health service delivery points. This problem also exists with some of the peripheralhealth centers even with Bissau. In other more remote areas, communication is hampered by thelack of two-way radios.

15. In terms of other control systems, MINPH currently lacks an effective system to monitorthe use and maintenance of vehicles and equipment throughout the health care system. Routinemaintenance and servicing logs have not been used, nor has there been any recent systematicattempt to inventory MINPH vehicles and spare parts. The recently appointed Director ofEquipment (Patrimony) has expressed interest in and willingness to implement a maintencesystem. Lack of available funds and personnel has heretofore affected this effort.

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GUINEA-BISSAU

HOSPITAL SUB-SECTOR

1. Health care services are offered at national, regional and sectoral hospitals, at health centers(clinics) and at community-managed village health posts (USBs). Private hospital care has not beenavailable. However, under the current liberalization it is likely that some doctors might be allowed toopen up private practices in the not too distant future. The country receives substantial aid fromforeign governments as well as from non-governmental organizations (NGOs), which support theGovernment-managed health care institutions.

2. Basic health services are provided in the health centers and in the sectoral hospitals, which arethe lowest of the three categories of hospitals in the country. The 121 health centers treat outpatientsonly and, theoretically, have catchment population of 5,000-12,000.

3. The 14 sectoral hospitals have catchment populations of 20,000-60,000 and an average bedsize capacity of about 25 beds. There is a significant variation in sectoral hospitals with regard tosize, catchment population, and services provided. Some do major surgery (e.g., in Catio), whilemost tend to restrict the services to outpatient treatment, maternity, laboratory tests and minor surgery(e.g., Farim, Quebo). The sectoral hospitals have, as a norm, a staff consisting of two doctors, twonurses, eight auxiliary nurses, two midwives and one auxiliary lab. technician. These hospitals areintended to serve as a transition point between primary health care and hospital services.

4. The five regional hos2itA vary in capacity between 60 and 110 beds, and offer moreadvanced services than those offered in the sector hospitals. However the practice varies. Theregional hospitals are supposed to offer obstetrics, surgery, pediatrics, radiology, and widerpharmaceutical services. Only one hospital has in recent times been able to provide the full range ofservices: the regional hospital in Canchungo, which until recently was operated by the Chinese. TheChinese ceased their assistance to the Canchungo hospital when Guinea-Bissau recognized theGovernment of Taiwan. As a replacement, a Taiwanese team is expected to take over the hospital'soperations.

5. The two national hospitals located in Bissau-Simao Mendes and Tres de Agosto-represent thetop of the health care pyramid, having approximately 44% of the hospital beds in the country. SimaoMendes has 411 beds and Tres de Agosto 223. The latter is reserved for the treatment of chronicillnesses, while the full range of services from surgery to dermatology is available at Simao Mendes.(Table 1 shows the distribution of hospital beds by facility category; Table 2 shows the distribution ofhospital beds by medical specialty; and Table 3 depicts the activities at the various hospitals in thecountry in 1988/89.)

KEY SUB-SECTORAL ISSUES

Staffing. Recruitment and Training

6. Physicians, pharmacists, certified nurses, auxiliary nurses, midwives and laboratorytechnicians represent the type of practicing health personnel in Guinea-Bissau. In January 1989 there

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were 116 doctors in Guinea-Bisau (Table 4), of which approximately 50% were expatriates. Themajority of doctors and nurses worked at national and regional hospitals.

7. Current staff ratios are below the norms provided by the Government (Tables 5 and 6), exceptfor medical doctors at the tertiary level (national and regional hospitals) and auxiliary nurses at thehealth centers. In the sectoral hospitals there are 1.1 physicians on average per facility, against anorm of 2.2 and only 1.0 registered nurses on average, opposed to a target of 4.6 (Tables 5 and 6).In the health centers, there are just 0.5 registered nurses on average, compared to a norm of 1.1.This means that one out of every two health centers is without a nurse. Regional imbalancesexacerbate the ratios: In 1987/88 there was one physician per 7,473 inhabitants nationally--adoctor/population ratio that exceed WHO recommendations. In Bissau the ratio was one per 13,430(Table 7). This means that Bissau, with 14% of the population, has 54% of the doctors and 45% ofthe registered nurses. The most disadvantage regions were: OIO (1 physician per 53,430 inhabitants)and Tombali (1 per 33,450).

8. A Cuban-supported medical school was started in 1987. This school is intended to providetraining in epidemiology and public health issues adapted to meeting the country's requirements. Thefirst class of about 25 students is expected to graduate in 1922. The school is severely constrained bya lack of resources. The supply of textbooks is very limited, and most are in Spanish and of Cubanorigin.

9. No students have enrolled in the 3-year school of nursing in Bissau during the last two years.This is attributable to the unfavorable working conditions for the graduates: low status, lack of careerdevelopment, and low salaries. This situation will exacerbate the health personnel situation in thefuture. (The salaries for health personel in October 1990 are listed in Table 7; for comparison, theprice of 50kg or rice was around GP 65,000.)

Facilities. Equipment and Supplies

10. Most of the country's hospitals are in a poor state of repair and lack essential equipment.Maintenance is generally poor. Many hospitals also lack safe water supplies and reliable sources ofelectricity. Some sector hospitals, which were constructed during the last few years, are inreasonably good condition; however, they rapidly deteriorate without proper maintenance. Most ofthe hospitals also lack essential supplies. There is an urgent need for bandages, suture materials,plaster-of-paris, gloves, disposable syringes, needles, and other disposables. There is also a constantneed for uniforms for the personnel and bedsheets for the patients.

11. The supply of drugs and medicines is uneven and irregular. Many essential drugs (such asantibiotics and anethetics) are in short supply. Most come from the national drug depository plussome foreign donations. The drugs arrive approximately at monthly intervals. The quantities are lessthan required and the supply is irregular.

Financing and Cost Recovery

12. Domestic funding for health care is very limited and is declining in both absolute and relativeterms. However, exact numbers for the hospital sector have been difficult to obtain. Arecent report estimated actual cost recovery of total health expenditures in 1988 at US$9,448, or0.5% of MINPH recurrent expenditures. However, these revenues were not generated at the hospitallevel, but primarily at the level of the health centers and USBs. Unitl now there has been no cost

ANNEX I -,3Page 3 of 17

recovery at the hospitals: impatient stays and outpatient visits have been free of charge; in fact therehave been fees of GP 60-100 per consultation, which has been unchanged in nominal terms since1978. In addition, a large proportion of the population has been exempt from paying this deductible.Thus, the contribution of this cost recovery has been negligible.

13. A proposal to increase fees by 600% to 1,000% was made in 1988, but has never beenapproved by the General Assembly. In the fall of 1990, however, the General Assembly approved aprogressive reform in this area, introducing a fee for service system. There is now a price list givingspecific prices for a number of procedures and activities: injections, vaccinations, physical exams forcertificates, minor surgery, major surgery, dental services, radiology, physiotherapy, and laboratoryservices, etc. For radiology and physiotherapy the prices are listed in two categories, with a higherprice (about double) for ambulatory than hospitalized patients. Some samples from this price list areshown in Table 9. The effect of this recent reform is hard to estimate. In theory, it should work ifsrvices at lower levels are adequate. However, if health centers are staffed with unqualified personneland the lower levels have an insufficient supply of drugs and materials, the pressure on the lowerlevel facilities is unlikely to diminish.

14. Until recendy, drugs have also been free of charge at the hospitals. However, duringstockouts for drugs in the hospitals, patients might have been forced to buy their own drugs at a localpharmacy. Under such circumstances the hospitals frequently have prioritized their inpatients andchildren under treatment.

15. The capacity to administer user fee schemes already existed in hospitals in Guinea-Bissau.Previously, however, user fee revenues have not been retained at the level of the health facility, butpassed on to the new reform, some of the collections will be retained at the level of the healthfacility, some will be kept at the regional level, and some will be at the disposal of MINPH.

PRIVATlZATION

16. During the current wave of liberalization, the opening for private practice is under discussion;in fact, a few experienced physicians already treat patients outside the hospitals. However, this hasnot yet become widespread and it is not clear what the recently established medical Association'sattitude toward this is and how private practice will be regulated.

17. Private health care services can at best become a high-end option for the population ofconsiderable means, but no an option for the general population. Figures, such as GP 15,200-20,000for a private consultation, were heard in October1990 (as compared to GP 5,000 for outpatient visitsat a national hospital iz Bissau under the new reform to be implemented from November 1990).

THE NATIONAL HOSPITALS

18. The two national hospitals have to a large extent complementary activities (Table 10). TheSimao Mendes Hospital is responsible for acute care, while Tres de Agosto is responsible for most ofthe chronic conditions requiring long-term treatment.

19. At Tres de Aiosto Hospital there are units for orthopedic rehabilitation, physiotherapy, ear-nose-throat disorders, stomatology and tuberculosis. The hospital has had no funding for maintenanceor repairs; built by the Portuguese in the late 1950s, it is now in ruins and beyond repair. The mainstructure is currently not in use for patients, and only the administration is located there. The rest of

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the hospital is also in a deplorable state. Patients with chronic or long-term illnesses are in dark,dirty pavillions or one-story structures. The original kitchen is not in use and a substitute one isbelow any acceptable standard.

20. The Simao Mendes Hospital is a district hospital for Bissau and the country's primaryreferral center. It has 411 beds and offers a wide range of services. It is also associated with theCuban-supported medical school. Table 11 shows the distribution of beds according to medicalspecialties in the hospital in 1990. The hospital consists of many pavilions that are scattered over alarge area and were built by the Portuguese in colonial times. There is a huge variation in thestandards among the buildings: some were built during the past decade (pediatrics, maternity, centraloperating facility, laboratory for tropical medicine), while others are rather old (radiology, emergencyroom, general surgery, internal medicine). During the past year some units have had a face lift, byrepairing cracks in the walls and painting the units (administration, general surgery, medicine,maternity unit and kitchen). These repairs were, in part, funded by IDA under the SocialInfrastructure Relief Project (SIRP). Some minor plumbingis nearly completed (emergency room)and small extension project in the blood bank is in progress. There are plans for further developmentand construction by the African Development Bank; however, these plans have been in existence forsome time and it is unclear what their current status is. The plans are thought to include theconstruction or refurbishing of the emergency room and the units for radiology, orthopedic traumas,stomatology and ear-nose-throat disorders. Rehabilitation and construction work was expected to startin 1989, but has not yet begun.

21. The Simao Mendes Hospital is primarily staffed with doctors from Guinea-Bissau and Cuba.In addition, laboratory services have been supported by European agencies: the blood bank by Italy;clinical chemistry by France; and the tropical medicine laboratory by Portugal (Table 12). Thevarious laboratories seem to work reasonably well and have been strengthened over the past fewyears. They all have equipment acquired in the past 2-3 years and get supplies financed andorganized through various European agencies. The blood bank is funded by Italian aid and seems tobe well equipped. The tropical medicine laboratory is about a year old an well equipped.

22. At Simao Mendes Hospital, as well as at other health facilities, there is a lack of certainequipment and a chronic unsatisfied need for supplies. On the equipment side, at Simao Mendes thelack of X-ray equipment is striking. The readiology unit has one old Italian X-ray system(Eurocolumbus), a second-hand unit installed and adapted for use in the hospital in February 1986.The unit is probably about 20 years old, and spare parts are difficult or impossible to obtain. This isthe only proper, stationary X-ray tube in the country. In the central operating facility there is aportable Philips unit which to some extent serves as a back-up systtem. The automatic developingsystem is out of order and one old film-drying unit is only partially working; there is also a lack offilm. It was observed that a lot of antique and defective equipment is stored in the hospital. Thelaundry unit has only two working washing machines, which means there is much hand-washing ofsheets and clothes. To dry laundry it is laid out in the open fields to be dried by sun. In the generalsurgery unit the spacing between beds is only approximately 30 cm, with 28-30 beds in one room.Both ophthalmology and medicine have bed units of the same type. The pediatric unit has 113 bedsand approximately 500 admissions per month. The unit has enough space and seems satisfactory.The rooms are smaller than in the other wards. The unit has a separate small laboratory, which iswell equipped. Most of the pediatric patients suffer from malaria (close to 90% according to one ofthe ward physicians who was interviewed), however that may not be the reason for their hospital stay.In the operating facilities there are four theaters built after the colonial period. Many wards in thehospital lack tap water, and in some that have tap water the water pressure is extremely low.

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ANNEXI-3Page 5 of 17

23. The Simao Mendes Hospital is respnsible for paying and planning salaries and providingsupplies; however, MINPH is responsible for personnel recruitment. The managing director of thehospital report directly to the Secretary of State for Health. (Figure 1 shows the organization chart forSimao Mendes Hospital.)

24. Other problems faced by the hospital are a lack of forms and documentation of patienttreatment, which creates problems with the continuity of care, and inadequate statistical monitoring,which primarily is a central reporting systemwith little or no feedback to the personnel capturing thedata.

25. Units that should have priority in future plans and modernization at Simao Mendes Hospitalshould include radiology, the emergency room, and the out-patient clinic.

CONCLUSIONS

26. The hospital sector in Guinea-Bissau can be characterized by a few statements about thecurrent problems. The situation today is essentially unchanged from that of a few years ago andefforts over the past three years have not significantly reversed the situation. Essentially, the hospitalsub-sector suffers from structural problems, with an unequal distribution of health personnel and anunequal distribution of hospital beds across the country. The distribution of hospital beds acrossregions varies considerably, drom 0.2 to 4.6 beds per 1,000 inhabitants (Table 13). There is awidespread lack of infrastructure and transportation. Furthermore, the activity of hospitals at the samelevel shows considerable variation, with some sectoral hospitals offeringmore complex services thanhigher-level facilities. There is an overconcentration of hospital beds and health personnel in thecapital. This unequal access to health care suggests that structural changes are needed,with anemphasis on primary health care. Health services in the most disadvantaged regions should bestrengthened.

27. Another problem is the lack of skilled people for performing many necessary tasks. There is ashortage of skilled health personnel, in particular doctors and certified nurses, with too manypositions for nurses staffed by personnel with less education.

28. In all categories of health facilities there is a striking lack of maintenance of facilities,equipment and vehicles. In most of the hospitals there is need for replacement or renewal ofequipment. The constant shortages of drugs and supplies remain a chronic condition, which severelyconstrains the impact of the curative services. This is largely a financial problem, but also can beattributed to inefficient purchasing, inadequate planning, and logistical problems. THere is also totalreliance on continuous external assistance to cover the recurrent costs of health care.

29. The emphasis on primary health care should continue, with the ggal of improving health andsocial indicators. The structure of the hospital sector should be coherent with this strategy, aimed atgiving support to the lower levels of the health care system in addition to serving as a referralnetwork.

30. Over the short term there are several measures that can be considered in the hospital sub-sector in order to get the most out of existing hospital facilities and equipment:

- Set up programs for maintenance of building, including efforts to mobilize thecommunity;

- 14 -


- Standardize vehicles and equipment in future purchases, thus reducing the learningand maintenance of skills for repairs, and obtaining quantity discounts on the purchases-in sum,realizing the benefits of economies of scale;

- Regulate or provide incentives for the redistribution of health personnel to lower-levelfacilities;

- Strengthen the status of health personnel (training programs, uniforms, a system ofincentives);

- Prepare guidelines for the rational use of drugs with broad participation from themedical staff; and

- Improve the continuity of care in the hospitals by strengthening and emphasizing thevalue of medical records and documentation; and provide pre-printed formulas for properdocumentation, with currently are in short supply.

c:hospsub.sec mr

- 15 -


HOSPITAL SUB-SECTOR

Table 1: Health Facilities and Beds by Facility Category

No. of No. ofUnit Beds

National Hispitals 2 701

Tres de Agosto 485Simao Mendes 216

Regional Hospitals 5 479

Bafata 102Bolama 70Gabu 100Canchungo 135Catio 72

Sectoral Hospitals 13 363

Special Hospitals 2 150

Lepra (Cumura) 90Psychiatry 60

TOTAL 22 1,693

Source: MINPH

-16 -

ANNEX I - 3

Page 8 of 17

HOSPITAL SUB-SECTOR

Table 2: Hospital Beds by Specialty (1989)

No. of Beds

Medicine 288Surgery 230Dermatology 8Gynecology 42Obstetrics 196Pediatrics 178Ophthalmology 23Urology 20Orthopedics 83E-N-T 5Stomatology 8Tuberculosis 202Leprosy 90Psychiatry 60

Source: MINPH

- 17 -


HOSPITAL SUB-SECTOR

Table 3: Activities at Hospitals in Guinea-Bissau, 1988/89

-------1988------- -------1989-------No. of No. of Occu- Averagepatient outpat. pancy lengthdays visits rate of stay

Simao Mendes 90,770 24,617 81 7.1Tres de Agosto 78,095 14,337 75 65.5Bafata 14,903 27,645 73 6.5Bolama/Bijagos 7,430 5,264 37 9.0Canchungo 12,750 128,472 37 13.1Gabu 16,284 39,593 86 5.1Bubaque 7,165 6,563 1/ - -Farim 5,562 15,726 67 5.5S. Domingos 2,706 13,200 35 5.4Sonaco 6,196 9,565 96 15.1Bissora 2,993 12,392 31 7.8Catio 4,287 5,941 - -Cacine 3,022 - - -Fulacunda 1,492 2,147 54 4.1Empada 1,847 4,994 58 6.8

Source: MINP81/ 1988 figures

- 18 -


HOSPITAL SUB-SECTOR

Table 4: Health Personnel in Hospitals of Guinea-Bissau, January 1989

Sectoral Regional NationalHospitals Hospitals Hospitals 1/ TOTALS

Physicians 16 39 47 115(incl. cooperants)Registered Nurses 15 53 215Auxiliary Nurses 71 152 1,097

Source: MINPHL/ Mission estimate, 1990

Table 5: Targets for Number of Health Personnel(in National Health Plan)

Regist. Aux. Lab._MD Nurses Nurses Tech.

National Hospitals 60 120 240 46Regional Hospitals 32 64 128 16Sectoral Hospitals 32 64 128 32Health Centers - 135 270 135

Source: MINPH/WHO, 1989 (3)

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ANNEX I - 3

PaRe 11 of 17

HOSPITAL SUB-SECTOR

Table 6: Difference Between Targetand Actual Number of Personnel (1989)

Regist. Aux. Lab.MDs Nurses Nurses Tech.

National Hospitals +10 -10 +28 - 3Regional Hospitals + 7 -11 -76 - 3Sectoral Hospitals -16 -49 -57 - 17Health Centers 0 -71 +24 -102

Source? MINPH ?/WHO, 1989 (3)

Table 7: Health Personnel by Region (1987/88)

Regist. Aux. Inhab. Inhab/MDs Nurses Nurses /MD Reg.Nurse

Bissau AS 70 113 268 2,448 1,517Bafata 13 19 81 10,954 7,495Biombo 5 11 11 13,340 6,064Bolama 6 12 51 5,050 - 2,525Cacheu 15 29 83 10,300 5,327Gabu 12 25 56 10,650 5,809Oio 3 18 47 53,453 8,905Quinara 3 11 43 14,567 4,856Tombali 2 12 74 33,450 6,575

TOTAL 129 250 714 7,473 3,935

Source: MINPH/WHO

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ANNEX I - 3

Page 12 of 17

HOSPITAL SUB-SECTOR

Table 8: Salaries for Health Personnel in PG(Estimates October 1993)

MDs 616,000Registered Nurses 328,250Auxiliary Nurses 174,800Lab Technicians 328,250Aux. Lab Technicians 174,800

Source: Administration Simao Mendes Hospital

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ANNEX I - 3

Page 13 of 17

Table 9: Selected Items from Price List for Medical Services- (Valid from November 1, 1990)

Outpatient Visits PGsNational Hospital 5,000Regional Hospital 3,000Sectoral Hospital 2,000Health Center 1,000

InjectionsSubcutaneous 500Intramuscular 1,000Intravenous 2,000

Minor SurgeryThoracocentesis 5,000Lumbar puncture 5,000Superficial abscess 2,000Circumcision 5,000Articular puncture 3,000

Major SurgeryVaricocele 15,000Hernia 35,000osteosynthesis 40,000Hydrocele 15,000

RadiologyForearm 5,000Clavicle 10,000Chest 10,000Stomach+duodenum 25,000

Hematology

Hemoglobin 1,000

Hematocrite 2,000Protein electrophoresis 3,500

Clinical biochemistryC-reactive protein 1,500S-glucose 1,000

S-bilirubin 1,000S-albumin 2,000Alc.phosphatase 2,000SGOT 1,000

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ANNEX I - 3

Page 14 of 17

HOSPITAL SUB-SECTOR

Table 10 Division of Labor Between the National Hosoitals(Number of Beds, 1989)

Simao Tres deMendes Agosto

Medicine 90Surgery 87Dermatology 8Gynecology 42Obstetrics 52Pediatrics 98Ophthalmology 14Urology 20Orthopedics - 83E-N-T - 5Stomatology _ 8Tuberculosis - 202

Source: MINPH

-23 -

ANNEX I - 3

Page 15 of 17

HOSPITAL SUB-SECTOR

Table 11: Distribution of Number of Bedsat Simao Mendes Hospital (1990)

Medicine 84General surgery 86Dermatology 12Urology 10Ophthalmology 16Pediatrics 113Obstetrics 62 (In practice + 20)Gynecology 41

TOTAL 411

Table 12: Nationalities of MDs at Simao Mendes Hospital (October 1990)

No. of MDsGuinea-Bissau 21Cuba 20Egypt 2Italy 1France 1Portugal 2

TOTAL 47

-24-


HOSPITAL SUB-SECTOR

Table 13: Distribution of Hospital Services by Region (1993)

No. of No. of No. of beds perhosp. beds population 1,000 inhab

Bissau AS - 2 701 1 218,114 3.2Bafata 2 137 150,.338 0.9Biombo 3 136 61,548 2.2BolamalBijagos 2 102 26,913 3.8Cacheu 2 155 149,693 1.0Gabu 2 122 141,535 0.9Oio 2 82 160,284 0.5Quinara 3 79 47,613 1.7Tombali 3 129 75,615 1.7

TOTAL 21 1,643 1,031,653 1.6

l/ Exclusive psychiatric hospital in Bissau.

Source' IPsUC,MINPH

-25 -

ANNEX I - 3

Page 17 of 17

HOSPITAL SUB-SECTOR

Figure 1: Organizational Chart - Simao Mendes Hospital (1990)

ManagingDirector

Clinical Administr.Director Director

Chief of--Medicine -Finance

--General Surgery -Statist.

-Dermatology -Supplies

-Pediatrics -Kitchen

-Urology -Cleaning

-- Obstetr/Gynecology -- Laundry

-Bloodbank -Secret.

-Clinical Chemistry -- MedicalRecords

- 26 -

- 27 -

ANNEX I 4Page 1 of 8

INTERNATIONAL AND DONOR ORGANIZATIONS INVOLVED IN THE HEALTH SECTOR

(A Partial Listing)

There are a number of international donor and non-governmental organizations (NGOs)actively providing subsidies and contributing technical assistance to MINPH in Guinea-Bissau. Inaddition, several countries are actively providing technical and clinical assistance to MINPH. A briefprofile of each organization, listed in alphabetical order, together with their resources and mainactivities is presented below. (This list, which focuses on support for MCHIFP, is undoubtedlypartial and incomplete, with numerous other organizations such as UNICEF and UNDP, as well asASDI and others, providing financial and technical assistance to the health sector).

1. Name ofOrganization: Associacao da Guinea-Bissau para Educacao e Promocao da Saude Familiar

(AGBEPSF).

Type andDescription: An NGO and Guinea-bissau affiliate of the International Planned Parenthood

Federation (IPPF) based in London.

Location (s): Bissau - Main Office and Model Clinic.

PhysicalFacilitie: AGBEPSF has a well-equipped facility with offices, training/waiting room

and consultation rooms located in the Santa Luzia Bairro of Bissau.

Human Full-time staff: an Executive Director, two parteiras, a health educator, aResources:chnician, and a driver. Part-time staff: a physician (OB/Gyn).All staff are Guineans.

PrincipalActivities: Founded in Bissau in 1988. Provides clinical family planning and

gynecological medical services, including physical exams, training and healtheducation (incl. family planning and STD prevention). Methods provided:OC pills, IUDs, Depo-Provera, Neo-Sampoon, spermicides and condoms.All services are provided free of charge. In the future AGBEPSF maycharge a small fee for its services. AGEPSF's annual budget is US$110,000.Budget increases are 5% per year.

Comment: AGBEPSF plans to expand its activities to other regions in Guinea-Bissau.discussions are planned with MINPH concerning the region (s) (e.g.,Bolama, Bubaque, Oio, Tombali) in which they could offer services toaugment or complement MCH/FP. In the area of training of professionalstaff, including the training of trainers, AGBEPSF could provide significantassistance to MINPH. They have access to other IPPF programs andresources (e.g., training materials), that have also been used successfully inAfrica and throughout the world. IPPF provides additional regional technicalassistance from Lome, Nairobi and London.

- 28 -

ANNEX 1 -4Page 2 of 8

2. Name ofOrganization: Clinica Evangelica de Biombo (CEB).

Type andDescription: A religious and missionary NGO affiliated with network of evangelical

organizations in the UK.

Location (s): Biombo, Quinhamel.

PhysicalFacilities: CEB is a well-equipped health center that includes maternity and delivery

rooms, a laboratory and pharmacy. there is a large clinic waiting room, alsoused for health education.

HumaResources: Full-time staff comprising four expatriate (UK) nurses (three are midwives)

and national staff comprising six nurses (two are midwives), two nursingassistants, a laboratory technician with three clinical/clerical assistants, and adriver.

PrincipalActivities: CEB was founded in 1955. General medical services, including MCH and

family planning to a rural population, the majority of whom are of the Papeltribe. CEB offers pre-natal care, obstetrical services and post-partum follow-up care. Clinic services and preventive health education are alsoaccompanied with Christian missionary activities and religious services. CEBreports an average of 250-300 clinic visits per day. FP obtains a modestamount of medications from MINPH. The bulk of the drugs and supplies areshipped to CEB direct from UK. All services are provided free of charge.

Comment: CEB plans to disengage its expatriate staff and turn the entire operation overto its national staff in 1993. For 35 years CEB has been an important sourceof medical care in the region. It has an active program to support birthspacing and has campaigned locally to encourage having smaller families andpromote individual and community preventive health.

3. Name ofOrganization: Clinica Catolica e Hospital Maternidade de Quinhamel.

Type andDescription: An NGO, affiliated with and supported by the Roman Catholic Church.

Location (s): Quinhamel.

PhysicaFacilities: A well-equipped and maintained clinic and maternity hospital, kitchen and

pharmacy, located in a rural region.

-29-


HmanResources: Full-time staff comprising several expatriates (Italians): three nurse midwives

(catholic nuns), and a health technician and administrator (a CatholicBrother). Six Guinean nationals, who include a nurse, two nursing assistants,a cook, and a cleaner.

PrincipalActivities: Regional maternal and child health services-outpatient and inpatient.

Obstetrics, physical exams, family planning, and post-partum follow-up care.The head nurse provides some nutritional education to expectant and nursingmothers. Contraceptives are provided to women and men who request them.Methods available: OC pill, condoms and spermicides. All services areprovided free of charge.

Comrnent: Clinica Catolica gets support form MINPH and from churches and otherorganizations in Italy. Many of the drugs are received directly from Italy.Many of the drugs are received directly from Italian pharmaceuticalcompanies. Limited staff permits home follow-up on a regular basis. Theambulance for transport of patients to the maternity hospital, and if necessaryto Bissau, is not in service.

4. Name oQrganizaLign: Danish International Development Agency (DANIDA).

Type andDescrption: Governmental, an agency of the Royal Danish Government.

Location (s): Bissau, some DANIDA supported staff in other locations in Guinea-Bissau,and construction sites indicated below; additional administrative support fromcentral office in Copenhagen.

PhsiEacilities: Administrative offices, located in Bissau.

Resources: A physician and a nurse midwife, located in Mansoa; a physician and twomedical students in Bandim (bairro of Bissau); a physician in Bissau and an

- administrator/architect also in Bissau.

PrincipActivities: DANIDA's main activity in Guinea-Bissau involves construction, renovation

of partial equipping of health centers that provide MCHIFP. As ofNovember 1990 the DANIDA program included 13 centers in two regions(Oio and Biombo). The six health centers being completely rehabilitated arein Nhacara, Encheira, Guidage, Binta, Cuntima and Canjambari. The sevenbeing partially renovated are in Olassoto, Port Gole, Mansoa, Mores, Dorse,Prabis, and Safim. DANIDA supports expatriate medical staff who providetechnical and clinical services to MCH/FP and are also involved in training,supervision, and the purchase of equipment and bicycles in the health centers.

- 30 -


Comment: DANIDA's program in Guinea-Bissau provides important assistance toMINPH in strengthening physical facilities and health infrastructure needed toextend the coverage of MCHIFP services.

5. Naie ofOrganization; International Bank for Reconstruction and Development/World Bank,

Population, Health and Nutrition Project (PHN).

Type andDescription: International lending and development organization.

Location (s): Project location at MINPH in Bissau, World Bank's Resident Office in Bissauand Headquarters in Washington, D.C.

PhysicalFacilities: PHN administrative offices, located at MINPH, Bissau; World Bank Resident

Representative's administrative offices, Bissau.

ManResources: -- PHN maintains an administrative and support staff, totaling 16, who include:

a Project Director, an Assistant, to the Director, a messenger, a Typist, sixdrivers, four evening guards, and two servants. Technical expertise isprovided through short- and long-term consultants paid through PHN.

Activities: Population. Health and Nutrition Project (PHN) financed by IDA (Cr. 1800-GB). The project is funded for four years (1987 through 1991) at a totalcost of US$4.4 million. Its main objectives are: (a) 'improve the institutionalcapabilities of MINPH in planning, management and finance; and (b) tostrengthen the delivery of health and family planning services, especially atthe rural health center level". FP-related project activities includedemographic and health data collection through a national sample survey andhealth data collection through a national sample survey (InqueritoDemografico e Sanitario); the rehabilitation of selected health centers thatoffer MCH/FP services; training; and a diagnostic and planning study toassist MINPH MCH/FP in extending the coverage of FP services andstrengthen its administrative and management activities.

Comment: Additional consultant technical assistance is provided to PHN through andcoordinated by the World Bank in Washington. Its is anticipated that someadditional PHN activities will be continued or expanded in a Bank-financedfollow-up project.

6. Name ofQ.kganjizjin: Radda Barnen (Save the Children - Sweden).

TeandDescriptiog: An NGO funded from private donations and contributions by the Swedish

Government.

- 31 -ANNEX I4Page 5 of 8

Location (s): Bissau, administrative and additional back-up support provided throughStockholm headquarters.

PhysicalFacilities: Administrative offices, located in a residential compound, are equipped with

a personal computer, peripheral equipment, and training and educationalmaterials.

HumanResources: Full-time staff: three expatriates (Swedish) comprising a physician and senior

regional advisor, a nurse, and an administrator; also an office assistant and adriver (both are Guinean nationals). Part-time staff: a Swedish physician,who will be assigned from the Swedish Embassy and the SwedishDevelopment Agency (ASDI), to assist MCH/FP at the National ReferenceCenter in Bissau.

PrincipalActivities: Radda Barnen staff arrived in Bissau in October 1989 and are in the process

of starting up their technical assistance and other activities. According totheir development plan (1989-92), Radda Barnen will assist MINPH instrengthening the national MCH/FP program. The program's main objectivesinclude the construction of a new MCH/FP central facility, evaluation(program registration and statistics), training, and regional technicalassistance for the national programs that Radda Barnen established in CapeVerde and Sao Tome and Principe. the three-year project constructionbudget is 7.7 million Swedish Dron, or US$1.4 million.

omment: Radda Barnen has a successful record of long-term technical assistance forMCH/FP, and pediatric disability and rehabilitation programs. Its plannedGuinea-Bissau program will provide significant support to MINPH andMCHIFP. Because of its capabilities and experience it is also planned forRadda Barnen to play a significant role in helping coordinate the MCH/FPprogram.

7. Name ofOrganization: United Nations Fund for Population Activities (UNFPA).

Type andDescription: International donor organization/UN.

Location (s): Bissau. Additional assistance provide through Dakar, Senegal (RegionalOffice) and New York (Headquarters).

PhysicalFacilities: Administrative office for UNFPA activities and access to other facilities

located at UNDP.

- 32 -ANNEX I 4Page 6 of 8

HumaResources: Bissau has three full-time national staff: a national program assistant, a

secretary, and a driver. UNFPA/Bissau has access to additionaladministrative support from UNDP.

PrincipalActivities: UNFPA has had two long-term programs in Guinea-Bissau (1976 and 1986).

Both provided a variety of assistance for MCH/FP, ranging from constructionand renovation of clinic facilities to vehicles, training, seminar support,research, clinic equipment and supplies, and contraceptive commodities.UNFPA's technical assistance has been directed toward helping lower infantand maternal mortality rates and strengthen the FP program. UNFPA hasalso supported a program with the Ministry of Education (GBS/801PO2"Education a la vie familiale dans les Ecoles") that focuses on including FPtopics in the secondary school curriculum under a course entitled 'FamilyLife Education." Two other important activities involve the UniaoDemocratica de Mulheres (Women's Democratic Union) and are related tofamily planning (GBS/86/PO2 "Muller e Desenvolvimento"). One focuses ontraining of Rural Extension Agents to promote and reinforce the use of FPmethods; the other is involved with strengthening and promoting the status ofwomen. A third program (1990-93) was designed and will include:renovation of three MCH/FP reference centers, equipping of seven peripheralhealth centers, expansion of gross MCH/FP coverage by 20% and the use ofFP methods by 3%, promotion of more awareness of the benefits of childspacing, and prevention of STDs, and overall improvement of MCH/FPmanagement information system (MIS). The estimated cost of this MCH/FPprogram is US$516,000.

CoDmme.t: UNFPA's Regional Office in Dakar has a staff of program officers whoaugment the Bissau Office on a regular basis. It also coordinates technicalassistance and consultants from UNFPA, New York, and other location. Tofurther strengthen the program, beginning in 1990, UNFPA has decided tocontract with Radda Barnen and utilize its capabilities to help administer andcoordinate the 1990-93 technical assistance program.

8. Name oOrganization: U.S. Agency for International Development (USAID).

TYDe anDescription: Governmental, an international donor organization; part of the U.S. Foreign

Assistant Program under the Dept. of State.

Location (s): USAID Mission to Guinea-Bissau in Bissau.

RhyAicalFacilities: Administrative offices.

- 33 -


HumanResources: Two full-time expatriates: a resident representative, and a program assistant.

National staff comprise secretarial and administrative personnel and a driver.

PrincipalActivities: No mission-funded activities related to MCH/FP at the present time. In the

past, USAID/Bissau has coordinated and assisted in logistical support ofcentrally funded (Washington, D.C.) USAID project activities that haveincluded Guinea-Bissau (e.g., training, and shipment of condoms to MINPHhealth and FP training, including support for MINPH personnel to attendinternational seminars. Presently, USAID/Bissau provides logistical supportfor a centrally funded project activity involving CERPOD from Bamako,Mali that is concerned with helping Guinea-Bissau develop a comprehensivepopulation policy.

Comment: While USAID has a number of population and FP project resourcesthroughout the world, USAID/Bissau has no mission funds available tosupport MCH/FP activities; there are no future plans for any type of FP-related assistance.

9. Name ofOrganization: World Health Organization (WHO).

TyVe andDesription: International donor organization/UN.

Location (s): Bissau. Additional assistance provided through Brazzaville, Congo (RegionalOffice) and Geneva (Headquarters).

PhsicalFacilities: Administrative office for WHO activities and coordination, located at

MINPH. There are also a ASDI project office at the Derrick Geral de SaudePublica and an essential drug program located at the Deposito deMedicamentos at Hospital 3 de Agosto.

HumanResources: WHO has a staff of seven expatriates in Bissau: a Resident Representative,

two assigned to the ASDI program, and experts in health economics, watersanitation, MCH/FP, the essential drugs program, and medical anthropology.There are 10 national staff: administrators, drivers, clerical assistants, asecretary, and a servant.

PrincipalActivities: WHO began its activities with MINPH in 1976, and with UNFPA was one

of the first international organizations to provide assistance for MCPIFP.WHO's support has been in the form of training, fellowships, supply ofmedical equipment, and research. At present, WHO's medical anthropologistis collaborating with MCH/FP on a study of health practices among ruralwomen, including their use of FP methods.

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Other Donor-Provided Technical and Clinical Assistance

In addition to the projects and programs supported by the above-listed organizations, technicaland clinical assistance i,s provided directly to MINPH by six countries through internationalcooperation agreements. This technical and clinical assistance is an important part of the totalMCH/FP program. A brief description of the type and location of the various activities is set outbelow.

Cuag: The Cuban Government provides a team of physicians for MINPH who are active inthe MCH/FP programs in Bolama and Bissau. These physicians are involved in training and FPservice delivery.

France: The French Government supports a physician in Farim who serves as the Director ofthe Regional Hospital. this physician, sponsored by Cooperation Francaise, also directs the nationalMCH/FP program.

Ity; The Italian Government's activities are predominantly concerned with MCH/FP and areconcentrated in the Gabu Region. A team of Italian physicians, midwives and technicians comprisesthe core staff of the Centro Regional de Saude Materno Infantil - Centro de Saude Tiziana Bissau inGabu. The program provides training, vehicles, clinic equipment, patient education, contraceptives,and clinical FP services.

The Netherlands: The Dutch Government funded a two-year MCH/FP technical assistanceproject in Canchungo that ended in June 1989. the project consisted of two physicians (a marriedcouple, one of whom specialized in FP) and training and the supply of contraceptives. The DutchGovernment is recruiting another physician husband-wife team in order to reactivate the project sometime during 1990. In addition to the Canchungo project, a Dutch physician is assigned to theMCH/FP program in Quinara.

People's Republic of China (PRO: Funding was provided for the construction and equippingof a 250-bed regional hospital (Hospital Regional de Cacheu), located in Canchungo and serving theCacheu Region. The hospital offers tertiary care and traditional acupuncture and has a predominantlyexpatriate (PCR) physician and senior technical staff. The Hospital's Director is a Guinean. Inregard to FP, all methods and services are provided and there is surgical expertise in sterilizationoperations. Most of the sterilizations in Guinea-Bissau take place in this facility.

Taiwan - China: In mid-1990 following recognition by Guinea-Bissau and the abruptdeparture of the PRC delegation and technical assistance program, Taiwan assumed control of theCacheu Regional Hospital in Canchungo. This Facility is now staffed by a team of contractphysicians and other medical staff from the Philippines.

Union of Soviet Socialist Republics (USSR): The USSR contributes a cadre of physicianswho provide MCH/FP services at the regional hospitals Bafata and Gabu. USSR physicians form thenucleus of the medical staff in Bafata.

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ANNEX I -5Page I of 13

GUINEA-BISSAU

Table 1. - Maternal Mortality Rate Per 1000 Live Births Per Regions

REGIONAL HOSPITALSNational

HospitalYEAR

S imnaoBafata Bolana Cacheu Gabu Oio Quinara Tombali

Mendes

1987 4.4 38.4 6.3 5.1 23.0 9.2 7.6 4.6

1988 6.8 23.0 - - 26.4 1.8 18.7 4.7

1989 5.8 30.0 - 4.1 11.3 1.5 - 3.2

1990 3.2 26.4 - 8.3 13.0 - - _

1991 5.6 10.9 - 16.9 - 4.8 5.3

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ANNEX I - S

Page 2 of 13

GUINEA-BISSAU

.able 2. - Car Accidents and Victims 1986-1989

1986 1987 1988 1989 1990

Rest Rest Rest Rest Total

Bissau of the Bissau of the Bissau of the Bissau of the in

Country Country Country Countr: Countr

No. of accidents 343 47 392 49 412 81 381 63 739

No. of ih,ured 174 48 200 69 226 110 143 235 392

No. of deaths 15 12 9 14 17 46 25 Z7 83

Sjou.ce: De2ar:amento de Viaciao e Transito

37-

ANNEX I - S

Page 3 of 13

GUINEAA-BISSAU

Table 3. - PHC - Pre-Natal. Births and Consultations in uSsS

Pre-Natal Consult Births I ConsultationTotal No. No. Per Year Per Year I Per Day*

Regions Working of of 1USBs ASBs Matronas Total Matrona Total Matrona Total AS31993 1993 1993 1989 1989 1989 1989 1989 1989

Tombali 122 349 201 1.526 4.4 20,894 0.25

Cacheu 172 249 333 195 1.4 31 0.2 19,245 0.6

Gabu 140 371 314 1.149 4.2 815 3.0 34,026 0.5

Oio 169 542 357 241 2.1 " 140 1.2 29,989 0.5

Bolama 65 211 184 150 1.4 120 1.1 8,185 0.3

Bafata 123 368 260 1,458 8.1 955 5.3 25.143 0.7Quinara 49 149 100 186 1.9 158 1.6 11,783 0.5

TOTAL 840 12,239 1 1,254 13,379 1 2.7 3,745 3.0 149.266 0.45

(*) 7 types of cases, during 200 days

Source: MINPH - PHC Directorate

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ANNtX I * S

Page 4 of 13

GUINEA BISSAU

Table 4. - Primary Health Care Evolution and Potential PHCW Coverage Over 10 Years

DATA 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988

USB 14 19 45 68 88 147 248 308 375 449(Total)

New per year (5) (26) (23) (20) (59) (60) (60) (67) (74)

ASB (Total) 34 82 147 241 457 590 713 840 1.183 1,564

ASB per USB 2.4 4.3 3.3 3.5 5.2 4.0 2.9 2.7 3.2 3.4

Matronas (Total) 25 58 101 199 371 439 539 693 863 1,197

Matronas per USB 1.8 3.0 2.2 2.9 4.2 3.0 2.2 2.3 2.3 2.7

'Covered' Pop. 5,500 13,100 15,700 30,000 40,600 50,361 88,302 149527 163538 174818

Pop. per USB 353 689 348 441 461 34Z 356 485 436 390

Births permatrona per year 7.7 9.0 7.0 6.8 4.9 5.1 7.4 9.7 8.5 6.5

ASB consult.per day 2.4 2.4 1.6 1.9 1.3 1.3 1.9 2.7 2.1 1.7

0Surce MINPH - PHC Directorate

-39-

ANNEX T - 5Page 5 of 13

GUILNM-BISSAU

Table S. - PEC-Disease Consultations Held by ASBs in USBs, 1989

REGIONS Malaria Diarrhea Conjunct. Cough Injuries Pain Evacuat. TOTAL

Tombali 6,960 2,033 3,071 3,416 4,160 1,254 20,894

Cacheu 2,212 1,606 2,237 3,888 2,291 5,472 1,540 19,246

Gabu 10,149 2,201 3,840 4,747 3,513 7,640 1,936 34,026

Oio 6,860 4,555 5.337 3,587 3,982 5,609 59 29,989

Bolama 1,697 1,201 807 1,055 654 1,231 1,540 8,485

Bafata 7,551 1,799 4,074 1,109 3,447 6,846 317 25,193

Quinara 4,211 629 924 1,622 2,125 2,126 106 11,783

TOTAL 39,340 14,024 20,290 19,464 20,172 30,178 5,498 149,256

Source: Regional Statistics Information, 1989.

-40 -

ANN:X X - S

Page 6 of 13

CZUTEA-BISSALU

Table 6. Heafth Centers - Existing and In:ended Human Resources, 1989

Working Auxilia r Auxiliary Laborator-yREGIONS Health Nurses Nurses Midwives Auxiliaries Blue Collar

Centers Ex. Int.IntZ Ex.Int.IntZ Ex.Int.IntZ Ex.Int.IntZ Ex.int. Inr.:1 1993 1989 1989 1989 1989 1989

Bafata 12 10 3820 190 9 LO 90 8 10 80 9 10 90Biomba 6 7 6 115 Z2 12 180 1 6 17 4 6 67 2 6 33BollBijag. 16 4 13 31 15 25 58 2 13 1 1 13 76 10 13 77Cacheu 14 9 17 5Z 30 34 88 10 17 59 S 17 29 1 L7 6Gabu 18 9 13 69 27 26 104 3 13 23 6 13 46 0 13 0Oio 13 3 13 23 34 25 131 5 13 38 3 13 23 0 13 0Quinara 12 5 11 45 25 22 114 3 11 37 1 11 8 0 11 0Tombali 22 19 32 4 38 108 0 19 0 2 19 105 0 19 0Bissau 7 7 7 100 32 14 228 13 7 185 5 7 71 10 7 142

TOTAL 113 44 109 403 227 248 104 44 109 403 35 109 329 32 109 294

Source: G. Studies/'MNpH

Note: The distribution problem may be observed as the intense concentration in Bissau.

-41-


Table 7: HC Actendmencs (Real Coverage), 1989

RECIONS

ACrIVITIESAiombe Bafata solamx Cach.u Cabu Oio Quinars Tombali TOTAL

Consult. 24,743 - 1,7S5 29,781 18,410 3S,862 13,193 3,800 127,334Inj-ctions 9,759 - 434 12,700 11,961 18,174 3,5S0 549 55,1l7Sutures 32t - 1 663 S6l 919 271 92 2,78SSIncisions 283 - 11 414 252 1,790 1 78 3,029Oent. Extr. - - 4 38 - 362 - 27 421Evacuationxs - - - - 1s - - 20Births 329 - 1 683 611 919 271 92 2,785

Aux.Uidwlves 1 - 2 10 3 5 3 0 24Births/Aux.Mid./Week 6.3 - - 1.3 3.3 3.5 1.7 0 2.2

Total Oth-rs 36,037 - 2,220 43,617 30,8a6 55,641 16,783 4,344 188,Soo

Nurses * AuxNurses 29 - 19 39 36 37 30 4 224

Daily BirthsNurses/Aux. 6.0 _ 0.S 6.6 4.3 7.6 2.8 5.4 4.2

Source: Studies and Plan Cabinet! MhINPH

- 42 -


...

Figure 1: Reported Cases of DiarrhoeaGuinea-Bissau

35

1 -- ... ..............

20 . . . . ..

2 0 . .. ........... .... ..... .. ......... ... ... .. ........................... ....... ............ .. .. ................. ...... ... .... ..... ..

5 ... .............. ..... ........... ......... ..............................I....................... .. ..........I.......................... ................... .....................

0 1983 1984 1*985 1986 1987 1988 1989

SOURCE: DGPS/MINPH

-43 -


li 1

Figure 2: Reported Cases of MeaslesII Guinea-Bissau

3500 k- 11.1 1,

3000 .

2500 _\2241

2000

1103

500 _ ... .. .. ......

1 000 _ \ / \ /\ ..6

01983 1984 1985 1986 1987 1988 1989

SOURCE: DGPS/MINPHl

- 44 -


Figure3 Birth Assistance

Dcotcr 2.57None 3.52

1~~~~~~

SOURCE: DHS-PHN/MINPH

-45 -ANNEX I - 5Page 11 of 13

Figure 4 Place of Birth

77.78

Other1.22

17.3

He 2I th Center3.71


- 46 -


Figure 5: VWater at Home

Has but -e--hese 4

| ........ DHS-PHTapped.. .. ........ . ..... 6 .2 9......... .... Does not....... .... .. answ er

Fetches ~~~4.0481.26


Mlnistry of Pubilc HealthOrganizatlon Chart

NatlIonal Councll of

Mlnister of Pubilc Health Health

DlrectlngCouncl I

| Socr etary of State I

National -Health Inap H

Public Plan/Studies Human AdminHHealth Gen. Dlr & Coop. Res GBen Dlr. General Dlr'

Hygilene P l an./ 9tudliea H uman Ad mln.

and Epid. Dlv . Div. Res. Trg. Div. & Patrlm Dv

Pharm. Tech. Human Flnance8erv. Div.~ Plan. Comm. Res. Mgt. Dlv. Dv

Prim. In'l 1Health Care Div. Cooperation

Hospital Documentatlon/i norm.8ervices Dlv.

'ands. Hospital | ^Qlllri 1 | | FARMEDI IL P|ohool P,nr

lSo7r ln.or lol hoo

0 1

- 49 -


GUINEA-BISSAU

HEALTH AND MANAGEMENT INFORMATION SYSTEM (HIS/MIS)

Scope and Content

1. Guinea-Bissau's medical statistical system was developed in 1975 when health programs weresmaller and data needs considerably less than they are today. As health care programs and servicesexpanded, the need for accurate data and information also increased; however, production has simplynot kept pace with demand. Most existing health data are unreliable and gaps exist in many serviceand management areas (e.g., drug information, epidemiologic surveillance, personnel, PHC andMCH/FP). Information needed to measure the growth of the service delivery programs and theirimpact on health indicators is limited. Most data emanate from the service statistical system, andthese statistics have the potential to both over-and-under-report data. Compliance with recordinginformation may not be uniformly adhered to throughout the health care system. Hospital records mayalso lack precision, due to incompleteness.

2. The MINPH MIS is a manual system and has no automated data processing equipmentavailable to it. Most service delivery points lack adequate equipment and resources to performefficient data collection. Many of the administrative areas are small and housed in crowded clinicspaces, and many service delivery points are in need of renovation. The lack of data collection andprocessing resources, including microcomputers and software, as well as trained personnel, furthercomplicates the acquisition, processing and analysis of data. MINPH has expressed interest indeveloping its automated data processing capabilities so that it will be able to anticipate theimplementation of a future HIS/MIS. Presently there are few microcomputers, and competent trainedoperators. While the microcomputer obtained through the PHN Project has been given little use,interest has been expressed by several MINPH staff to participate in computer-related trainingcourses.

Data Collection and Analysis

3. Where it has been collected and is available, information pertaining to the use of healthservices is not separated by the various levels in the health care system that comprise the network ofservice delivery points. Data recording instruments, where they do exist, do not specify thequantitative and qualitative elements of service delivery. Data do not appear to be readily accessiblefor planning and/or administrative purposes. Because of a largely under-developed HIS/MIS, healthinformation in Guinea-Bissau may not be reliable.

4. MCH/FP data collection activities have included an HIS/MIS that was recently reviewed byUNFPA and through a 1990 study funded by the PHN Project. The MCH/FP data flow is as follows:

Patient registers and/or receives family planning servicesat the health center (HC). Information is recorded on apatient form and in a logbook by clerical or administrativestaff, or in some cases by clinical staff. Daily patientactivity is recorded and summarized at the end of month.

- 50 -


Monthly reports from the HCs are sent to the sectoralhospitals, which in turn sends them to the regionalhospital, where full-time statistical and administrativestaff prepare a summary for all family planning servicepoints in the region and then send it to MCH/FP and MINPHin Bissau. The National MCH/FP Center in Bissau sends itsstatistics directly to MINPH.

- Family planning regional reports are sent to the MINPHPlanning and Research Council, which redirects the reportsto the Statistics and Planning Center. When all data rereceived at MINPH, a monthly activities report is prepared.

- MINPH does not routinely distribute monthly or annualreports within the family planning system.

5. The current HIS/MIS is hampered by the incompleteness of data from reporting units and byserious delays in producing reports. Clinical service providers, program managers and administratorshave expressed frustration over the lack of timely and useful reports and feedback on their programactivities. The current system depends on full compliance with the data reporting requirements.Participation of all regions is an initial requirement that should be stressed by senior MINPHmanagement staff.

Available Health Indicators

6. There are few health indicators that are routinely prepared through MINPH collected data.Emanating from service statistics, most of the data have not been aggregated to attempt even anapproximation of health indicators. The recently completed Demographic and Health Survey (DHS)has not yet been fully analyzed. Current analysis plans for these data do not include the developmentof health indicators, since they may not have been identified as potential outputs when the DHSquestionnaire was designed. In essence, health indicators in Guinea-Bissau can only be developedfrom crude estimates or small-scale studies where adequate controls can be followed.

7. Mortality estimates by age and sex depend upon large sample surveys, complete censuses, andan effective vital statistics recording system. Guinea-Bissau has none of these and must continue torely on estimates and projections from the 1979 census. The national census planned for 1991-92should be extremely useful in addressing some of the national data needs.

Dissemination of Findings

8. Few useful reports reach middle and senior management, and consequently evaluation andplanning activities must be undertaken without complete information. MINPH and other ministriesrely on field reports and concentrated mission-produced documents as a source of information.Reports of this type usually are not disseminated at all levels. MINPH does utilize periodic meetingas a forum to discuss data collected through specialized studies; however, these studies are notconducted with regularity and therefore MINPH meetings to discuss their findings are unpredictable.

- 51 -

ANNEXI-6Page 3 of 3

9. Conclusions

(a) MINPH should require each operating department (e.g. MCH/FP) to draft (i) a detailedone-year operationallaction plan delineating all operating groups and their responsibilities; and (ii) atime implementation schedule of tasks and activities by week and month, including meetings andpresentations, reports, training courses,visits from international organizations and consultants, andanticipated field trips and vacations.

(b) A supervisory visit protocol and manual should be developed to enable each operatingdepartment (e.g., MCH/FP) to have a systematic checklist that could be completed for each sitevisited. A copy of the checklist should be left with or later sent to the site visited. Completedchecklists should be kept on file to facilitate tracking and follow-up.

(c) There should be a thorough review with senior MINPH staff of the objectives ofMINPH's current medical statistical system. Special emphasis should be given to reviewing theadequacy of the present data collection system, the quantity and quality of existing data, and thedevelopment of health indicators.

(d) A comprehensive health and management information system (HIS/MIS) should bedesigned and adopted for the entire health sector. The HIS/MIS will require system design,equipment, software and supplies as well as training and some external technical assistance.

(e) The use of health data and information by regional directors and administrators issuggested as a topic for future MINPH in-service training and could be a component of the HIS/MIS,

(f) MINPH should prepare guidelines for medical data collection. There should be areview of all aspects of the current MIS, including current forms used, registration and recordingprocedures and manuals, data reporting and transfer schedules, data processing, staff training, reportpreparation and dissemination, and the uses of the data for evaluation, management, and operationaland strategic planning.

(g) Consideration should be given to the introduction of a personal computer (PC) systemin MINPH to facilitate data processing. Personal computers are being used successfully by manyorganizations in Guinea-Bissau, and with minor operating environment modifications an appropriatePC system could be installed in MINPH. Tle computer could also be used for word processing,inventory control, and project and personnel management. In the longer term, additional uses couldinclude the management of patient records, laboratory results, inter-regional communication staffproductivity reporting,- and the development and utilization of medical data bases.

c:HIS/MIS.Ann (mr)

- 52 -

- 53 -

ANNEXES FR

CHAPTER I OF VOLUME H - EDUCATION AND TRAINING

ANNEX II - 1Page 1 of 5

GUINEA-BISSAU

LANGUAGE OF INSTRUCTION

1. Language of instruction. Portuguese is the official language of instruction in Guinea-Bissau, acountry with a multi-ethnic, multi-lingual and culturally diverse society. There are about 34 ethnicgroups, each with its own language. Very few Guineans are able to speak Portuguese, which rendersthe language of instruction policy difficult to implement. Under these conditions the intrinsiccomplexity of the foreign language learning process is increased, yet the need for absolute success isindisputable because if students fail to learn the language they may fail school altogether. Studentsmust master the Portuguese language at the proficiency level in order for it to serve as a tool ofcommunication in acquiring literacy numeracy skills in particular and in building and strengtheningcognitive and social skills in general.

2. The source of modeling plays a key role in the acquisition of a foreign language, and withinthe classroom the teacher is the primary model. At the beginning, students cannot use a language theydo not know, nor can they be creative with it without first mastering its basic elements. To achievesuch mastery, they have to start by listening to the phonetics and imitating them, repeating words andphrases, understandihg, and memorizing them; only then do the processes of application, transferenceand creativity occur. Gradually, students begin to apply the principles of the language and to use itsforms and structure as a means of communication. Finally, they are able to be creative in the use ofthe language and to perceive it as a personal means of communication.

3. Exposure to the language. This likewise plays a very important role in learning a foreignlanguage. Exposure facilitates its acquisition in general and in particular when learning is expected tooccur rapidly. In Guinea-Bissau intensive, prolonged exposure to Portuguese is very limited if onecompares exposure to the mother tongue to the shortness of the school day (four hours).

4. Teachiny cadre. Besides the inherent difficulties in pursuing an academic program conductedin a language that is not theirs and moreover is used only while they are in school, students are taughtby teachers who no only do not always master the Portuguese language themselves, but also aregenerally not well trained and have practically no support services and very limited teachingmaterials.

5. Difficult learning conditions. In sum, students do not have good models from which to learnPortuguese, do not have the benefit of intense, prolonged exposure to the language, do not haveproficient teachers to guide and coach them in learning and using it, and do not have the supportmaterials that could help them to help themselves.

6. Difficult teaching conditions. For the teaching cadre not to be proficient in Portuguese, not tobe well trained, and to lack adequate support services and materials all add up to a situation, and tolack adequate support services and materials all add up to a situation that has significant pedagogicalimplications for implementation of the language of instruction policy. In fact, these difficult teachingconditions partially explain the high dropout and repetition rates in primary education and the lowteacher morale that prevails in the country.

7. Strategy for implementing the policy. To alleviate the many problems arising from thissituation, and as an implementation strategy, the Government has proposed a transition program in

- 56 -


which the first two y ears of schooling are conducted in Crioulo; children are not introduced toPortuguese during those two years. The program has been tried out on a pilot basis in three regionsof the country and recently been evaluated. After further experimentation in the three regions, theGovernment intends to extend the program countrywide.

8. Implementation constraints. Implementation of the language of instruction policy -Portuguese, as the official language- and of the proposed strategy --first two years of schoolingconducted in Crioulo- faces a number of constraints. These comprise the lack of: (a) a nationallycommon mother tongue, (b) appropriate and adequate textbooks and other learning and teachingmaterials, (e) a national consensus on the best strategy, (f) objective and reliable data on the country'slinguistic situation, and (h) and agreed criterion for the choice of the strategy. A closer look at eachof these constraints will enhance our understanding of the issues to be addressed in implementing thelanguage of instruction policy.

(a) Lack of a Nationally Common Mother Tongue

9. This represents the main source of difficulty in implementation of the language of instructionpolicy and of the transition program as a strategy. The lack of a common mother tongue is a realitythat cannot be changed, but nevertheless it has to be dealt with because in the learning and teaching ofa foreign language it has the deepest impact. Lack of a common mother tongue in Guinea-Bissaumakes it impossible to prepare teaching and learning materials that specifically address learningdifficulties arising from the juxtaposition of the two languages: Portuguese as the foreign language,and the mother tongue that each student brings to school. Teachers to compensate for this situationby addressing specific problems that their students encounter at any given moment, in any particularaspect of the language, through specific learning activities in their mother tongue. For this reason,teachers should be assigned to geographic areas in which they can handle the local language;unfortunately, this is not always possible.

10. Since a primary source of difficulty in learning a new language comes from the student'smother tongue, it would be helpful if the teachers' biweekly sectoral meetings were expanded in scopeto cover specific problems that students encounter in their struggle with the language of instruction.Together, teachers could design pedagogical activities and supplementary materials to support theteaching and learning process.

(b) Lack of a Nationally Common Second Language

11. The proposed strategy of a transition program conducted in Crioulo is based on the existenceof Crioulo as a commoji second language throughout the country. If this assumption is correct, thetransition program would allow Guinean children to continue the development of their social,psychomotor and cognitive skills without disruption-i.e., to enter the academic world without thetrauma of a sudden rupture with their mother tongue and to move later, in a stronger position, to theforeign language. However, there is no consensus on how widely spread the use of Crioulo actuallyis, nor is there a consensus on how many in the teaching cadre can handle that language in ordinarycommunication, much less for using it to teach children.

12. If skeptics of the notion of Crioulo as a widely spread means of communications are correctin their estimation, the proposed transition program would amount to submitting children to theexperience of starting formal schooling in a foreign language (Crioulo), only to switch to yet anotherforeign language (Portuguese), two years later. Thus, they would undergo twice the trauma that was

- 57 -

ANNEX 1I - IPage 3 of 5

to have been avoided in the first place. On the other hand, if the assumption that Crioulo is widelyspoken in the country proves to be correct, the transition program would be fully justifiedpedagogically and its high cost in curriculum development, program design, production of materials,and teacher training would be outweighed by the benefit of improved learning and the savings that amore efficient means of instruction would represent for the country.

13. It is very difficult to determine accurately the country's actual linguistic situation. Whileoptimistic estimates account for 50%-80% of the population to be speakers of Crioulo, pessimisticestimated account for entire regions where many people, including teachers, do not speak Crioulo. Infact, there are reports of field visits during which the services of a translator were necessary to enablestaff to establish communications with teachers unable to communicate in either Portuguese orCrioulo, or in some case, in the local language. Moreover, most persons interviewed agreed that inthe eastern part of the country Crioulo speakers are few in number. There seems to be generalagreement that the majority of Crioulo speakers are concentrated in urban centers and, consequently,for the people in the tabancas across the countryside, Crioulo may be as foreign a language asPortuguese.

14. Just over a decade ago, according to the most reliable data (1979 census), an estimated 50%of the population spoke Crioulo and 10% spoke Portuguese. However, it is now generally agreednow that the linguistic situation has changed over the past decade. All current estimates point to theneed for a linguistic census because, if the post pessimistic prove to be accurate, the Governmentwould be about to implement a misguided policy that could lead to further deterioration of theeducation system. Clearly, one could hardly expect the acquisition of basic, functional literacy ornumeracy skills if the medium of instruction, rather than being a vehicle, were an obstacle tolearning. In this pessimistic scenario, the distress that the Government wishes to spare school-agechildren -avoiding an abrupt transition from their mother tongue to Portuguese- would, in fact, beinflicted upon them by the Crioulo language.

(c) Lack of Well-Prepared Teachers

15. Ideally, primary school teachers should have a solid basic education, skills in classroommanagement and in how to teach specific subjects, and proficiency in Portuguese as the officiallanguage of instruction and in Crioulo if indeed the transition program is institutionalized.Unfortunately, this ideal is not met by the teaching cadre in Guinea-Bissau, hence effective teachingunder present conditions is a nearly impossible task.

16. While an optimal level of teacher education is not possible for the immediate future and underpresent circumstances, the country must undertake a serious and sustained effort to upgrade theexisting teaching cadre in the subjects of the curriculum, in teaching methods and general classroommanagement, and in Portuguese -and Crioulo, if needed-- through an intensive, prolonged andcumulative in-service training program. Only when teachers have acquired these competencies andbasic knowledge and can function as literate and fluent speakers, will they be able to teach the schoolprograms effectively.

17. When asked about the number one problem in the education policy-makers, school principals,inspectors, and teachers themselves agreed that the low level of teacher qualifications is the mostimportant deficiency in the education system. When asked about teacher-specific problems, theteachers placed lack of opportunity for improvement as teacher problem number two, number onebeing the very inadequate teacher salaries.

- 58 -

ANNEX II - IPage 4 of 5

(d) Lack of Appropriate and Adequate Textbooks and OtherLearning and Teaching Materials

18. Appropriate textbooks and other instructional materials are woefully insufficient in Guinea-Bissau. Without the support of content-accurate and pedagogically sound materials, teaching andlearning become even more difficult. However, in a country with scarce human and materialresources it probably would be more prudent not to divert talent, time and money into textbookdesign and production, but rather to focus on the design and production of student manuals andteacher guides. Also, priority should be given to producing a wide spectrum of working handouts, asstudents would benefit much more from the availability of such handouts than from a single textbookwith no support materials.

19. Imported textbooks are not likely to be relevant to the country's socio-economic, cultural andlinguistic context, whereas suitably designed handouts could provide such relevancy through theirexamples and exercises that support the attainment of a given lesson's objectives. They need not beon high-quality paper, but should be in ample supply. Locally produced materials would be usefulnot only to students and teachers, but also to the Normal schools for training future teachers in thedesign and use of materials; furthermore, instructors could assist in the preparation of manuscripts.

20. Adaptation of basic textbooks, as efficient as this may be, should not be done at the expenseof producing support materials of the kind suggested above - varied and plentiful and complementedby an assortment of other materials for display and reference purposes.

(e) Lack of National Consensus on the Best Strategy

21. Lack of a consensus on the best strategy for implementing the language of instruction policymay derive from the subjectivity of opinions, based on personal experience and biases. Also, manyof those concerned with this issue are not fully aware of the impact that any given choice has on thelearning process, teacher training requirements and the production of support materials, or of thelogistical and economic implications. In the effort to reach a consensus, experience gained in thetransition program underway as a pilot in three regions (para 7) will be helpful, and also theexperience of other African countries. Many have wasted precious time, sometimes as much as 20 to30 years, debating the issue of the language of instruction and the many possible implementationstrategies without reaching a decision and taking action; meanwhile, several generations of childrenmay have missed what would have been their only opportunity to learn.

22. The experimental transition program --teaching the first two years of basic education in theCrioulo language- could profit from further analysis to identify areas in needof support or change, so that the necessary changes to improve its efficiency may be made. Thus far,over 50% of the students have either failed the course or dropped out of the program.

(f) Lack of Adequate Objective and Reliable Data

23. Not having adequate objective and reliable data on the country's linguistic situation (paras 13and 14) contributes to the difficulty of reaching a consensus on the best strategy for implementing thelanguage of instruction policy. A linguistic survey would provide objective, reliable data that wouldserve as a means to reconcile divergent estimates of various people with diverse background,experience and expectations, and sometimes looking at the issue from different perspectives.

- 59 -

ANNEX II - IPage 5 of 5

24. In the absence of the linguistic data needed to determine the best implementation strategy, theGovernment has to listen to a wide range of advice and opinion offered by (a) teachers and students,who have their interest at stake; (b) curriculum and program designers, textbook designers andproducers, researchers and other technical staff, school principals, and inspectors, who have theirexperience and expertise to offer; and (c) policy-makers, because although the consequences of thelanguage of instruction policy and its implementation strategy fall into the pedagogical, technical andeconomic areas, the issues are cultural, psychological and political in nature.

(g) Lack of an Agreed Criterion for Choice of the Strategy

25. Lack of agreement on the criterion for the choice of a strategy to implement the language ofinstruction policy is yet another constraint to resolving this issue. Elaborating the advantages anddisadvantages of alternative choices from the point of view of all concerned --users, implementers,technicians, policy-makers and political leaders-- would help in reaching agreement on a criterion forchoosing the best strategy. Transparency is the issue here. Should efficiency of the education systembe the criterion? If not, what should it be? Taking into account motivations would be the single mostfacilitating element in the difficult process of reaching a decision on the best strategy. Then thecountry could decide whether it is ready to pay the price and live with the consequences of decision.

Recommendations

26. The Government should take a stand without further delay on the strategy for implementingthe language of instruction policy. Once the decision is reached, the Government must allocateadequate time, economic and human resources to implementing the strategy. Though risks areinvolved in taking decisive action, mistakes made initially could be corrected and proceduresimproved. Guinea-Bissau cannot afford to repeat the experience of some African countries that tooktoo long in debating the issue of the language of instruction and thus deprived children of their onlyopportunity to become literate and more productive.

27. Whether the Government decides to continue to introduce Portuguese as the language ofinstruction from Grade I onward, or to extend country wide the experimental transition program inCrioulo, a major effort should be made to upgrade the teaching cadre. This should include: (a)improving teachers language skills; (b) improving their knowledge of the subjects in the curriculum;(c) improving their capability to manage the classroom through increased awareness of therelationship between teaching activities and student responses and the consequent development of arepertoire of varied teaching activities; (d) providing teachers with a stock of pedagogically sound andcontent-accurate support materials; and (e) undertaking major improvements in the teacher supportservices of the Inspectorate.

28. A program should be undertaken to produce learning and teaching support materials thatpromote better use of students' learning time and of teachers' teaching time.

29. Finally, the Government should consider developing and promoting effective ways to increaseexposure to Portuguese.

- 60 -

- 61 -

ANNEX I1 - 2Page 1 of 6

GUINEA-BISSAU

THE SITUATION OF THE PRIMARY SCHOOL TEACHERS

1. There are not enough teachers in Guinea-Bissau, and the majority of the current teachingstaff are not able to fulfill their mission. The main constraints are low levels of general education,insufficient teaching skills, lack of proficiency in the official language of instruction,lack of sufficientinstructional materials, lack of incentives and opportunities, and extremely low salaries.

Not Enough Teachers

2. The opening of the 1990/91 school year was delayed because of a lack of enoughteachers. Three regions were unable to fill a combined total of 182 teaching positions for lack ofapplicants. To resolve this problem, the Government approved over-time for 111 teachers to teachdouble-shift and in this way cover the needs.

3. Teachers are leaving the school system because of the low salaries and the lack ofincentives, and also because the profession does not offer the pride and satisfaction that hold people injobs despite adverse economic conditions. Moreover, local sources of employment compete with theeducation system for the best-qualified individuals, and able teachers willing to abandon theirprofession can do so easily. Frequently those who leave the system find occupations abroad; thisaffects the country on three counts: a decrease in the number of professionals, loss of quality, andloss of invested training resources. Under current conditions and for the near future there is noreason to expect the number of teachers to increase. The Normal School for primary school teachersoperates below capacity because of the low number of applicants. With a student/instructor ratio of5.5:1, it is clear that, under current conditions, the teaching profession os far from being a top careerchoice in Guinea-Bissau.

4. Without a high input of out-of-school experience or exposure to modern means ofcommunication, Guinean children depend exclusively on teachers for any kind of academic education.With their high level of illiteracy and low level of education, parents are unable to teach children thebasic numeracy and literacy skills needed in today's world. Hence, the country cannot count onparents for direct, academic support. An effort should be made to attract teachers to the system andto retain them.

5. With a student/teacher ratio of 29:1, the education system is not using teachers' time atmaximum potential. Raising the student/teacher ratio from 29:1 to 30:1 would help solve theproblem of the shortage of teachers and it would maximize the efficient use of human resources.

Low Level of General Education

6. Primary school teachers in Guinea-Bissau have not had an opportnity to achieveacceptable levels of general education that would allow them to master the subjects in the curriculum.Primary school teachers have less than the desirable minimum level of general education: only 12.7%have completed between four and five school years; 32.6% have completed between six and eight

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years. An effort should be made to raise the general education level of all primary school teachers.Teachers need to thoroughly know the subjects in the curriculum that they teach; ideally they shouldbe ahead of it, as only very able and experienced teachers can effectively assist others in learningsomething they themselves do not know. An education that is the equivalent of secondary schoolingwould be a reasonable target for the next decade. Raising the general education level of primaryschool teachers to the equivalent of secondary schooling does not imply that hose joining the teachingcadre should be required to have a complete secondary education; such a requirement would beunrealistic for the next few years. The education system has the best teaching cadre now available.It is those teachers who must be supported by raising their general educational level through astrategy that does not necessarily involve sending them back to school, much less on a full-time basis.

7. The experience of other developing countries should be considered in upgrading theteaching cadre. Drawing from the experience of others may spare the country prolonged periods ofspeculation and loss of learning opportunities for the children now in the system. Learning fromothers may also help avoid costly mistakes in the development and implementation of teacher-trainingprograms. Sending teachers back to school while they continue teaching is an alternative that couldprove efficient. Teachers choosing this alternative should be recognized, and compensated for theirtime devoted to study. Service and accountability should be asked in return.

8. Special attention should be given to upgrading the inspectorate program to enableinspectors to fulfill the objectives. Among complementary alternatives to upgrade teaching quality arethe teaching quality are the creation of learning support center, the development of peer groups, andthe production of written support materials and educational programs to be transmitted by radio.

Insufficient Teaching Skills

9. Most of the teachers have not had an opportunity to develop the basic teaching skills thatwould allow them to (a) impart information with accuracy and clarity; (b) interact with students toguide the learning process, monitor activities, and give feedback (reinforce, redirect, give cues,correct); (c) take full advantage of textbooks and other printed materials (identify main ideas,recognize the purpose of exercises, understand the process, and conduct the learning activitiesaccordingly); (d) develop a variety of exercises for students to practice memorizing, analyzing,applying methods and practicing procedures, and solving problems; (e) prepare practice exercises forlearning in class and for homework; and (f) continuously assess students' learning difficulties. It isthrough these and other pedagogical practices that competent teachers engage students in the processof learning; this is how effective teachers motivate students to further learning. The Governmentshould make a serious effort to upgrade the skills of the teaching cadre.

10. Pre-service training would help build a base for the schools of tomorrow. The childrennow in school, however, need effective teachers. Each year that goes by without effective teachingconstitutes a loss for the country's youth; each year more children will become frustrated, lose hope,develop a poor self-image, lose the strength to try, and finally abandon the education system. Eachyear without effective teaching increases the number of children repeating grades, and the countrywill continue to waste its scarce resources. The government needs to give high priority to upgradingits teaching cadre.

11. A strategy should be devised to train teachers in a gradual, incremental, and sustainedmanner, and to seek sources of financing for the program. Only a solid basic education program anda functional teacher training program will enable teachers to perform the roles of being competent

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ANNEX H - 2Page 3 of 6

channels of information, effective guides in the learning process, and sources of inspiration.Awareness of the low status of teachers in the country was expressed by many interviewed in 1990,and all welcomed the Government's proposals to alleviate the situation. Whatever means theGovernment chooses to upgrade teachers, it should be a complete program that combines variousmeans with maximum efficiency. One of the most efficient means would be the strengthening of theinspectorate services.

Teachers Do Not Master the Language of Instruction

12. Lack of mastery of the language of instruction (Portuguese), constitutes a majorhandicap for the education system. With some 34 ethnic groups that speak about the same number oflanguages, the language of instruction poses a challenge to the education system; according to the1979 census, only 10% plus of the Guinean population were able to speak Portuguese just over adecade ago. Although speakers of Portuguese are considered to have increased in numbers over thepast decade, no reliable data are available. According to the 1979 census, less than 50% of Guineansspoke Crioulo at that time, Crioulo being nonetheless the most widely spoken language in thecountry. There is no up-to-date information on the number of Crioulo speakers and estimates have awide range, from 50% up to 80%. Other major languages spoken in the country are Balanta, Fula,Mandinga, and Manjaco. Although the Government tries to assign teachers to regions where they arecapable of speaking the local language, this is not always possible and communication in theclassroom is not always easy. Surrounded by a family that, according to the 1979 census, probablydoes not speak Portuguese, students have to learn it to the level of proficiency to be able to learn thesubjects in the curriculum.

13. By their own admission, teachers lack mastery of Portuguese and there are many who donot speak it at all. Furthermore, there are many teachers who admit to not being able to speakCrioulo, and there are a considerable number who claim not being able to speak either Crioulo orPortuguese. In a recent survey among Grade 1-4 teachers, 81% declared being able to speakPortuguese, usually in conjunction with another language; 62% declared being able to speak Criouloonly, or in conjunction with another language; and 14% declared not being able to speak eitherCrioulo or Portuguese.

14. The Government should strengthen the training of teachers in Portuguese. An in-servicetraining program is essential to enable teacher to implement the language of instruction policy; such aprogram should be massive, intensive, well articulated, and sustained. To be successful, the programshould aim at developing skills in (a) using Portuguese proficiently for the purpose of communication;(b) teaching Portuguese to students as a foreign language, to the level of proficiency; (c) using it inthe classroom for the purposes of teaching subjects in the curriculum; and (d) rationing and balancingthe use of the students' mother tongue, or Crioulo as the case maybe be, to expeditiously solve anycommunication problems that may arise in the classroom.

Lack of Sufficient Instructional Materials

15. Teachers in Guinea-Bissau are in a precarious situation with regard to the availability ofinstructional materials. Traditionally all books were imported. A major effort is underway toprovide sufficient and appropriate instructional materials, and the Government is engaged in thedevelopment, adaptation, production, and reprinting of textbooks for students and manuals forteachers. Among other instructional materials, 88,623 books were distributed (i.e., left thedistribution center) in school year 1988/89 for children registered in Grades 1-3, with an average of

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ANNEX HI-2Page 4 of 6

1.4+ books per student. Among the books distributed were: (a) 11,000 reading books and 21,000math books for Grade 1, resulting in .4 and .8 books per student, respectively; (b) 8,371 readingbooks and 16,852 math books for Grade 2, averaging .4 and .8 books per student, respectively; and(c) 7,000 reading books and 5,600 math books for Grade 3, or .5 and .4 books per studentrespectively. All these ratios assume that all books distributed reached the children; however, someestimate that only about 70% of books reached them. If these estimates are accurate, only 29% firstgraders, 29.8% second graders and 36.3% third graders had reading books for the 1988/89 schoolyear, rather than the respective percentages of 41.4% for first graders, 42.5% for second graders and51.9% for third graders if the reading books had reached the schools. Furthermore, it is estimatedthat about half of the children who had access to books are in Bissau. According to the testimonies ofstudents, teachers, supervisors, school principals, and parents; (a) the majority of children in ruralareas experience an absolute lack of books; (b) many schools in the country do not have books; (c)many schools have books but only for some subjects; (c) there are parents who cannot afford to buybooks, even though books are heavily subsidized; and (e) there are problems with distribution.

16. Books are produced by the National Press (a public enterprise under the tutelage of theMinistry of Education) INACEP and distributed through private businessmen; however, there is noavailable information to establish the difference between number of books produced and the numberdistributed to schools. Due to the favorable prices asked for books in schools as compared to pricescharged in the free market, many books are sold in the black market. Some claim that many parentshave to buy books in Bissau where people are ready to pay higher prices and therefore the books arein higher supply; others claim that a portion of the books find their way to neighboring markets.Further distribution problems result from the practice of fixed quota of school supplies (booksincluded) per region, regardless of the number of schools or children in the region. Many teacherscomplain about not being able to avail themselves of books and other available instructional materialsbecause they cannot afford them; teachers are supposed to buy their own books and school supplies.

17. With regard to indispensable instructional materials other than books and schoolsupplies, in many tabancas there are schools without a blackboard, and in most rural schools theblackboard is a piece of wood or badly painted and cracked cardboard resting on top of a student'sdesk or chair. In general, in spite of the effort to provide the school with instructional materials, theyhave no dictionaries, globes, maps, charts of posters.

18. The school environment relates to instructional materials in that it supports teaching andlearning. Light plays an important role; in may 'make-shift' schools, patterns of sharp contrast ofbrightness and shadows are projected on the paper on which the children write, making it hard ontheir eyes. Many rural schools are poorly lighted and not ventilated. Teachers are left alone in theseenvironments, often without instructional materials or support from the community.

Lack of Incentives and On,Rortunities

19. The teachers have no incentive to give the school system any time beyond the requiredfour hours per school day, because they engage in a variety of activities to provide for their needs andthose of their families. Unfortunate as this is, it is understandable. There are reports about manyteachers who take time from school hours or simply do not go to their school to teach. the teachersalso lack the incentive of specific opportunities to further their education and training, as well as anopportunity to participate in decision making. Were these opportunities available, teachers wouldgladly take them; this was evident in the enthusiasm that the recent consultation on the pedagogicalreform expressed by all the participants. The 'consulta" took the form of a series of seminars and

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workshops offered to over 300 individuals, including teachers, school principals, inspectors, andsectoral and regional delegates. Each of the 300+ participants was expected to replicate theexperience with 10 teachers.

20. The teachers lack the incentive of frequent, reliable and functional supervision. Onereason for this is that the inspectors work under conditions that do not allow them to supervise allteachers in a regular and functional manner. Finally, the teachers do not have the incentive ofworking in an orderly, clean school. The schools lack budgets for repairs and general maintenance.The majority are in disrepair and many are dirty. In general, students are not expected to collaboratein this regard, parents do not get involved, and teachers are not committed to taking schoolmaintenance into their hands or to involving children and parents. At the sectoral or regional levels,no one seems to be responsible or accountable for school maintenance.

Low Salaries

21. Teachers do not have the incentive of earning a salary on which they can live or be ableto provide nutritious food for their families. The majority of teachers' salaries do not equal the priceof rice to feed a household of four for a month. Under these circumstances, it is not surprising thatteachers are deserting the system and that there is no perspective for increasing the ranks of teachers;in fact, the Normal School for primary teachers operates below capacity. Currently, the Governmentis holding discussions with the World Food Program (PAM) in hopes of organizing a food supplementprogram for teachers.

Conclusions

22. To improve the quality of primary education in Guinea-Bissau, it is essential to (a) trainthe teaching cadre, (b) supply sufficient instructional materials, and (c) pay teachers an adequatesalary.

23. An in-service teacher training program is vital to revitalizing the education system. Thetraining program should include the language of instruction (Portuguese), and Crioulo if the transitionprogram is expanded; the subjects of the curriculum; and teaching methods. The training programshould be intensive, and sustained; it should be comprehensive and include aspects of teaching beyondclassroom management, such as class preparation, development of learning activities and testingactivities, and ways to complement available instructional materials. Training methods should bepractical, conducted through active learning and guided by the principles of adult learning, andinclude specific approaches to teaching the language of instruction as a foreign language and to usinginstructional materials.- Clearly, the training program cannot be implemented in a single episode. Itmust be designed with a long-term perspective and implemented by stages, in cumulative fashion. Astrengthened inspectorate service would be the most effective means to reinforce and complement anyteacher training program.

24. Instructional materials should be sufficient and adequate to children's developmentalphase in learning (graded with ascending degrees of difficulty) well articulated (continuous sequencebetween grades), and support active learning. Portuguese or Crioulo instructional materials should bedesigned for the purposes of teaching/learning a foreign or second language as the case may be(Portuguese reading books currently are not designed as foreign language textbooks and there are nosupplementary materials to compensate). Instructional materials should reflect the socio-culturalrealities of the country.

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25. Raising salaries sufficiently for teachers to be able to dedicate themselves to a full-timeteaching career is a prerequisite for any program aiming at improving the education system.

26. It is recommended that a comprehensive program be undertaken, including (a) an in-service teacher training program, (b) the provision of adequate instructional materials, (c) thestrengthening of the inspectorate service, and (d) an increase in teacher salaries. It is understood thatan equally serious training program for inspectors is a prerequisite for an improved inspectorateservice. External assistance may be required.

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GUINEA-BISSAU

TECHNICAL AND VOCATIONAL EDUCATION

Introduction

1. In the past few years the Government has shown increasing concern for human resourcedevelopment in the areas of business administration, agronomy, and mechanics. Shortages ofqualified manpower have placed constraints on the country's economic development. Hence an efforthas been made by the Ministry of Education (MOE) and the international donor community toestablish better coordination among education and training, personnel planning, and manpower needsin the various sectors. To address this problem MOE was assisted by donor agencies in establishingthe Institute for Technical and Vocational Training (ITFP) in 1980; however, as a result of theliberalization of the economy, ITFP needed to adapt to the new governmental concepts to meet thenew labor requirements. This led to creation of the National Institute for Technical and VocationalTraining (INAFOR) in 1989, succeeding ITFP. Additional funds were provided by privateinternational donors from Cuba, Denmark, Portugal, Switzerland, the United Kingdom, and TheNetherlands to improve the non-formal training system.

2. INAFOR's main objective is to respond better to the increasing need for trained personnel inboth the public and private sector; particularly, as the need for more administrative as well astraditionally skilled manpower became evident. The Institute's effort consists of developing a nationaltechnical and vocational training program offering courses for people with different levels ofeducation and skills: apprenticeship, retraining, and specialization. Total school enrollment for1990/91 is estimated at 1,354 (excluding the Rural Development Training Center (EFC).

Description of INAFOR

3. The National Institute for Technical and Vocational Training comprises four schools: theIndustrial Training Center, the Administrative Training Center, the Agricultural Production School,and the Rural Development Training. The first two are located in the Bissau area and the other twoin the southern regions - Quinar (Empada) and Tombali (Bedanda), respectively. Women represent36% of the total enrollment rate, as shown in Table 1.

(a) The Industrial Training Center (CENFI) has a teaching staff of 52,which includes one woman. The courses range from mechanics toplumbing and electricity. In 1989, 271 students were enrolled in thethroo-year apprenticeship training, of whom 20 were women.

(b) lbe Administrative Training Center (CENFA) offers coursesranging from accounting to secretarial. During 1990, 213 studentswere enrolled in the short program course. Female enrollment isthree times greater than that of males. Job opportunities and salariesfor students completing this course are better than for CENFI.

(c) The Agriculture Production School (EPCV), teaches agriculturalmechanics and related courses. In 1989, 91 students (17 werefemales) completed the course.

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(d) The Rural Development Training School (CEFC), with a teachingstaff of 21, offers courses in a variety of areas such as typing, civilconstruction, and literacy. About 566 students were enrolled in 1989(222 were females). The low teacher ratio impacts negatively on thequality of the program.

Table 1: INAFOR: Distribution of Full Time Students for 1989/90

Type of School MEN WOMEN TOTAL WOMEN %

CENFI, Bissau 251 20 271 7.3

CENFA, Bissau 1/ 59 154 213 72.3

EPVC, Empada 74 17 91 18.7

CEFC, Bedanda 344 222 566 39.2

Total 728 413 1,141 36.2l Data for 1990/91

Source: INAFOR: Planning Cabinet, 1990/91

4. Since 1975, the technical education institutions in the country have largely benefitted fromfour projects, financed by the UNDP and the International Labor Organization, that led to the creationof ITFP (GBS/75/018, GBS/76/009, GBS/82/003) and INAFOR (GBS/87/009), respectively. Thelatest project, completed in 1989, included a pedagogical component for ensuring the training ofinstructors who were either trained at local schools or sent abroad for specialization courses. Thenewly trained instructors have now participated in teaching programs within the technical trainingschool and outside in enterprises that provide on-the-job training. However, the school currentlyfaces the problem of retaining its newly trained staff, due to the rapidly increasing demand of privatesector enterprises for qualified manpower. Since the technical school was placed under the Ministryof Education in 1980, a total of 2,256 students were trained at in the various training centers: 1,093at CENFI, 820 at CENFA, 128 at CEFC, and 60 at EPCV.

5. To provide a suitable policy and institutional environment for a comprehensive approach totechnical and vocational issues, the Government strengthened the structure of the organization in1989. INAFOR is headed by a General Director, assisted by three advising bodies: the ConsultingAdviser, the Managing Director, and the Planning Cabinet. The General Director, with the supportof the three advising entities, oversees three departments: the Technical Services Department, theOperations Services Department, and the Administration and Financial Services Department. EachDepartment handles a different aspect of the school system: training/employment linkage, thetechnical and vocational training program, and administrative and organizational support; however astudy is being undertaken by NGOs to analyze the possibility of implementing school antennas in therural areas to facilitate access to technical education. In late 1990, 11 % of INAFOR's staff werewomen.

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ANNEX 11 - 3Page 3 of 4

Linkage between Training and Employment

6. Within INAFOR, a Production Unit has been created with the primary objective of improvingthe linkage between education and production and optimizing the use of the equipment. Althoughresults have been successful, the funds are being used to compensate for the low instructor salaries(PG 80,000 per month) rather than for reinvestment in materials and equipment.

Maior Constraints

7. The major issue affecting quality training is low salaries, despite the recent salary increasesproposed by the Government. An instructor earns an average salary of GP 80,000 per month. Thisproblem has resulted in a high exodus rate to better-paying jobs. With regard to middle-managementpositions, the demand for both training and qualified personnel is particularly high, given the growinginfluence of the private sector in the economy.

Donor Participation in INAFOR

8. Several government and non-governmental organizations have contributed to the financing ofthe Institute. The Dutch NGO, SNV, has in its education project a component that assists CENFA indeveloping an administration course on project implementation in rural areas. This program alsoexamines how women can be incorporated in productive activities in their regions. Africare ispreparing a project on the reorientation of the technical and vocational curriculum of INAFOR for theProduction School in Empada and the Rural Development Training School in Bedanda. Technicalassistance will consist of designing a course on the training of instructors and management consulting.

Other Schools

9. In addition to the existing governmental institutions, two new centers related to technical andvocational education have been established in the capital to address the increasing needs of the publicand private sectors for skilled personnel:

(a) The 'Centro de Reciclagem e Aperfeicoamento do Comercio' (CRAC)in Bissau and Gabu, financed by D.D.A. (Swiss Cooperation) underthe IDA Second Technical Assistance Project, and has been inoperation since October 1987 for the purpose of improvingGovernment institutional planning. The courses include budgeting,accounting, and data processing. During school year 1989/90, 238students were enrolled in the program, of whom 43% were women.CRAC has graduated 300 candidates in the past three years. Theexact student placement follow-up has been difficult to monitorbecause of the limited availability of permanent staff at the center(four people) and ministerial restructuring. However, most studentshave returned to the positions they held prior to enrolling in thetraining program. Only about 4.75% of the students have changedpositions as a result of the acquisition of new skills at the center.

(b) A more recent institute, REGISGUICOS, LDA in Bissau, offerscourses to industries and small businesses in computer operations,such as accounting and word processing. Also, the company will be

- 70 -ANNEX II - 3Page 4 of 4

offering accounting services to various companies. There were 20graduates since October 1989 and there are 40 newly registeredcandidates for the next session. This private organization has fourfull-time instructors and two parti-time instructors.

Recommendations

10. It is recommended that a better gender-specific information system be designed to monitorstudent placements. Better data availability could reduce the current imbalance between technicaleducation and the needs of the labor market. The training program should shift from training onlylower-skilled labor to train administrative and middle-management skills. Participation of the privatesector in the design of the curriculum would improve the education-employment equation.

11. Action should be taken to improve instructor salaries to discourage defections to other,higher-paying sectors. Inter-ministerial coordination is recommended to deal with these issues.

12. The participation of women in the technical training courses organized by INAFOR should beencouraged. Priority should be given to adapting the curriculum to enhance women's opportunities toenter the formal sector.

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GUINEA-BISSAU

THE USE OF TELEVISION IN EDUCATION

Histoy

1. In Guinea-Bissau the use of TV as an information medium is very limited. The frequentpower shortages in the country combined with the lack of a national TV channel has restricted the useof audiovisual techniques for education. However, since the recent establishment of an experimentalTV channel (TVE-GB) with the assistance of the Portuguese Government in 1988, efforts are underway to promote the use of TV for educational purposes.

2. To support this initiative, the Government has received support from Portugal in procuringand installing 100 pilot TVs powered by solar energy. The first number of TVs were delivered bythe end of 1991. Receivers are concentrated in Bissau and Bafata, but the arrival of the new setsshould contribute to the expansion of coverage to the rural areas.

Operational Aspects of TVE-GB

3. TVE-GB has developed an effective production capacity over the past two years and is nowentirely operated by local staff. The station is geared to broadcasting education and mobilizationmaterial, but needs technical assistance and recurrent cost support to both devise appropriate programsand do actual filming. Presently, Guinean TV broadcasts programs four times a week, from 8:00p.m. to 11:30 p.m.

Donor Participation

4. The national TV channel also broadcasts material supplies by other producers, notably theSocial Communications Department of the Ministry of Information, established and supported byUNICEF. UNICEF is currently designing a project that includes an audio-visual education andmobilization component specifically targeting women as part of its overall strategy to increasewomen's participation in economic development. This project, entitled "Training Rural Women forSelf-Employment in Improved Food Processing Storage and Marketing," is financed by FAO and willbe implemented by the Ministry of Rural Development. Its objectives are to convince producers ofthe existence of a potential market for diversified agricultural products, educate customers about thenutritional value of these new products, and inform buyers that the food preparation time andmonetary value will remain unchanged. The estimated budget for this project is US$356,000 for athree-year period. The project would benefit 1,500 women and their families in the rural areas, and2,000 in Bissau.

5. The UNICEF Social Communications Project is well placed to offer educational program-production services because it benefits from adequate equipment, supplied through UNICEF, but isconstrained by recurring costs. The training project, currently under design, will finance transportcosts, provide materials and specific technical support for preparing programs on the nutritional valueof the new food products, and mobilize materials in support of the new food-processing techniques.In addition, three technicians will be selected to be sent for short program production courses toeither Portugal or Brazil.

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ANNEX 1IIPage 2 of 2

Technical Trainini in Bissau

6. In 1989, INAFOR (National Institute for Technical and Vocational Training) established withthe support of the United Nations a course to promote the use of audio-visual methods for educationalpurposes. The two technical centers, the Industrial Training Center and the Administrative TrainingCenter in Bissau now have a design class, a photographic laboratory, a printing and book-bindingworkshop, a typing class, and an administrative office to prepare programs and didactic materials toorganize workshops and seminars.

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ANNEX 11-5Page 1 of 4

GUINEA-BISSAU

INTERNATIONAL AND DONOR ORGANIZATIONS INVOLVEDIN THE EDUCATION SECTOR

1. Donor support is of the utmost importance in the education sector of Guinea-Bissau. With theGovernment's education budget representing 12.4% of its total recurrent budget in 1989, efficientoperation of the education and training system is possible only through donor assistance; in fact, 89%of the 1989 education budget was allocated for salaries and wages, with about 80% of recurrentexpenditures in the sector financed by donors. Donor investments in the sector total US$40.15million, allocated for construction (55%), equipment and supplies (18%), administrative reform(14.4%), teacher training (6.8%), curriculum reform (3.5%), textbook production (1.5%),educational research (0.2%), and other (0.5%).

2. The main organizations supporting the sector are: the Swedish International DevelopmentAuthority (ASDI), the African Development Bank (ADB), the UNDP, IDA, the Italian Government,the European Community (EC), UNESCO, Dutch Cooperation for Technical and Social Assistance,Information and Documentation Center, Amilcar Cabral (CIDAC), Support for People's Development(ADPP, a Scandinavian NGO), Kinderdorf International (SOS, an Austrian NGO), French BilateralAssistance, the Gulbenkian Foundation, Instituto de Cultura e Lingua Portuguesa, Ministerio deEducacao de Portugal (ICALP), Africare (an American NGO), African Recruitment Organization(ARO, a Swedish NGO), United Nations Children Emergency Fund (UNICEF), OrganisationInternationale du Travail (OM"), the US Peace Corps, the World Food Program (PAM), Cuba, andJapan. The support of the four major donors-ASDI, ADP, UNDPIUNESC0 and IDA- issummarized below.

(a) ASDI: This oldest and largest investor in education in Guinea-Bissautraces back to 1969 when commodity aid was given during thestruggle for independence. ASDI's continuing support concentrates onprimary education, mainly (i) school materials, including theproduction and distribution of teaching materials; (ii) pedagogicalresearch; (iii) teacher training; (iv) institutional support, includingfinancing for office equipment and supplies and two long-termtechnical assistance posts; and (v) overall coordination and advisorysupport. ASDI's support is in the form of grants, which are releasedover agreed time periods. The current 1988-90 agreement amounts toabout USS4.4 million over the three-year period. Negotiations for anew agreement are under way.

(b) AM: The first grant agreement, signed in 1976, was mainly tosupport INDE. The second, signed in 1989 and intended to cover upto 1993, supports mainly (i) the National Institute of Technical andVocational Training (INAFOR), including a new building for theAdministrative Training Center (CENFA); (ii) institutional support forthe Planning and Projects General Directorate (DGPP); and (iii)rehabilitation of all the primary schools in Bissau. The amount for

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ANNEX II -5Page 2 of 4

school rehabilitation totals (US$1.5 million. INAFOR support totalsUS$12.6 million.

(c) UNDP/UNESCO: The UNDP has supported education in Guinea-Bissau since the 1970s. In a US$1.2 million project, the UNDPconstructed several schools in Bolama. It also supports INAFOR'sIndustrial Training Center (CENFI) with a project providing US$2.6million for a new air-conditioning program and technical assistance forthe instructor training program. The current agreement, covering upto 1992 is mainly concerned with curriculum development andplanning; the amount is US$1,225,000.

(d) IDA: Cr. 1914-GB, for US$4.3 million and signed in 1988, financesthe Basic Education Project, which supports (i) primary schoolrehabilitation and equipment, (ii) teacher and school inspector training,and (iii) institutional development.

3. A number of donors are negotiating additional education and training projects: SNV, tosupport CENFA; NOVIB of The Netherlands, to support CENFA; Africare, to support the RuralDevelopment Training Center (CEFAG); CIDAC, to support the Center for Educational and TrainingExperimentation (CEEF); the European Community, to support CEEF; ADPP, to support theconstruction of rural schools, with community participation; Radda Barnen - Save the Children(Swedish NGO), to support pre-school teacher training; the Peace Corps, to support secondaryeducation and the Teachers College; and PAM, to support primary education.

4. DGPP coordinates most of the education projects, with the assistance of the SIDA coordinatorfor education projects and advisor to the Directorate. The Ministry of Education holds quarterlymeetings with SIDA, and the SIDA advisor has taken a special interest in helping to coordinate WorldBank financed and other projects. However, the four major donors cited above, as well as the manyother development agencies working in Guinea-Bissau, need to improve coordination and work moreclosely together to avoid duplication of effort and maximize the effectiveness of their support to theeducation and training system. All the donors that are co-financing projects would gain more in-depthknowledge about the sector through a mutual exchange of ideas and experience. TwoGovernment/donor roundtables were held, in 1987 and 1988; this was a positive step towardimproving donor coordination and collaboration. More frequent meetings among donors and with theGovernment would create a synergetic effect that would enhance mutual understanding and allow forlonger-range perspectives on sectoral issues. Donor coordination was one of the topics discussed atthe Partners Roundtable held in April 1990; the Medium-Term Plan was a main topic on the agenda.Recommendations were made to seek ways to improve coordination among the donors. Examples ofprojects co-financed by donors that offer opportunities for interaction are:

(a) The Social and Infrastructure Relief Project (SIRP), an emergencyproject designed to counteract the social consequences of the StructuralAdjustment Program, has the financial support of, among other, IDA,SIDA, EC, Portugal and Japan. The project is expected to becompleted by 1992. The allocation for the education component isUS$600,000, for supporting the rehabilitation of the secondary schoolsin Bissau and some primary schools in the regions.

- 75 -

ANNEX IPage 3 of 4

(b) In the primary education sub-sector, (i) SIDA's support includesschool materials and textbook production, pedagogical research,teacher training, technical assistance, office equipment and supplies,school furniture, and institutional development; (ii) the IDA-financedBasic Education Project supports school construction and renovation,teacher and inspector training, institutional development, buildingmaintenance, equipment and furniture, vehicles, consultant services,and scholarships and study abroad; (iii) UNDP/UNESCO supportcurriculum development and will also help improve the capacity foreducational planning; (iv) the Italian Government supported theconstruction of nine prefabricated primary schools in Bissau, and hassigned a credit agreement for 1989-90 amounting to US$8.0 million;(v) CEE financed primary school construction, with SNV as executingagency; although the term of the agreement has ended, the Dutchagency continues to support the School Construction Unit of theMinistry of Education; CEE is also supporting a pilot program taughtin Crioulo, aimed at providing a transition to Portuguese as thelanguage of instruction in all the schools; (vii) SOS is financing schoolconstruction for pre-school and primary school age children in Bissau;(viii) the UNDP financed the construction of primary schools, for atotal of US$1.2 million; (ix) ARO supports the rehabilitation of schoolfacilities; (x) ICALP assists in the teaching of Portuguese as a foreignlanguage; (xi) French Bilateral Assistance supports the Frenchlanguage program; (xii) PAM has supported the operation ofkindergartens, Biombo's primary schools, teacher training, andboarding and semi-boarding schools by providing food to students andteachers at these institutions.

(c) In the technical/vocational education sub-sector, (i) ADB supportsINAFOR's technical and administrative professional training program.ADB financed construction and training at the Institute when it wasestablished, and continues to support CENFA, including a newbuilding, equipment, and technical assistance; (ii) CEE supportscurriculum development and teacher training, with CIDAC asexecuting agency; (iii) SNV supports CENFA in rural areas foradministrative training and the improvement of teaching materials; (iv)the UNDP supports INAFOR in industrial training at CENFI,including the center's new air-conditioning program and technicalassistance for the instructor training program; (v) SIDA and IDAsupport teacher training; (vi) Cuba provided instructors to INAFORfor industrial training; (vii) the USSR has offered instructors for T-Chico-Te, the Teachers College; (viii) Africare provides support forredesigning INAFOR's professional and technical training programs inrural areas, provides technical assistance for instructor training andmanagement consulting, and also supports training abroad; AROsupports INDE's efforts to improve the quality of teaching, and SNVsupports CENFA in administrative training in reorienting the program;and (ix) the Gulbenkian Foundation supports the teaching of

- 76 -

ANNEX II -5Page 4 of 4

Portuguese in the secondary schools through the preparation of newtextbooks, the production of teaching aids, and teacher training.

5. As donor coordination and support are essential at the present stage of development ofGuinea-Bissau's education sector, donor-financed projects should be an integral part of a sectoraldevelopment plan based on priorities and the most pressing needs. Top priority should be given toprojects that address the two most critical issues facing the sector: poor quality and low efficiency inthe education and training system. Sustainability of project benefits and achievements should besought by all possible means, notably through Government involvement in all education projects andin all phases, starting with project design. The Government should not seek external assistance forprojects the country cannot sustain; similarly, donors should not offer assistance for projects thecountry cannot sustain. This is an area in which donors have a comparative advantage because oftheir expertise and wide experience; hence they should be consulted in calculating the short, mediumand long-term prospects of success of any given project.

6. Guinea-Bissau needs a long-term development plan that addresses the main sectoral issues. Ifthe Government does not have the capacity to absorb an education project, cannot implement it orcannot provide counterpart funding or cover operating costs, donors have two alternative courses ofaction: either they do not invest in the sector, or they help the Government to develop the humanresources and the physical infrastructure to enable it to pursue its goal of 'education for all" andmake education programs functional and relevant to the country's needs. The long-term developmentplan should include a gradual phasing out of dependence on donor support. The present educationand training system cannot function without donors; the question is whether donors are supportingthey system's long-term development or whether, because of inadequate coordination, they areengaged in ad hoc activities and are working in isolation from one another and without a fullyfunctional partnership with the Government.

ZB:annii-5.gub (mr)

Table 1Priuary Zducation, Grades 1-4

School Ago Popul&tion 7-10, Enrollment Rates

Periodo de Poyulacao am id d M-tricula mnsino Taxa do oscolriz acao

Referncia o-aolar 7-10 * lmentarM F r TOTAL M F TOTAL M r TOTAL

1981/82 46,777 45,801 92,578 23,078 12,485 35,563 49.3 27.3 38.4

1988/89 50,448 50,714 101,162 25,366 15,199 40,565 50.3 30.0 40.1

1990/91 53,915 51,648 105,563 26,215 15,224 41,439 48.6 29.5 39.3

1992/93 54,851 52,281 107,132 23,575 14,121 37,696 42.9 27.0 35.2

1996/97 55,540 56,977 112,517 28,260 19,030 47,290 50.9 33.4 42.0

Fontes Kinisterio do Eduoaaao. Anuario Estatistico do Educacao. 1981/82 o 1992/93.

CZSO - Pr.paracao da Mesa Redonda don Parceiros don Dsenvolviwsnto

A:TAB1 (JZ24)

'-4

OQ

o 41h

l

Table 2Primary Education, Grades 1-4

School Age Population 7-12, Enrollment Rat-o/Gmnder

Poriodo de Populacao en idado Matricula *nnino Taxa de oscolarizacaoRef-rencia oscolar 7-12 *l_entar

M PI TOTAL M F TOTAL -H TOTAL

1981/82 67,495 64,045 131,540 37,353 20,647 58,000 55.3 32.2 44.11988/89 75,060 75,497 150,557 37,379 21,486 58,865 49.8 28.5 39.11990/91 79,415 77,011 156,426 36,986 20,623 57,609 46.6 26.8 36.81992/93 80,722 77,422 158,144 33,112 18,727 51,839 41.0 24.2 32.81996/97 84,749 91,113 175,862 37,412 22,487 59,899 44.1 24.7 34.1

co

Fontes Miniat.rio do Educacao. Anuario Eatatistico do Zducacao. 1981/82 * 1992/93.CZSO - Prgparacao da Mesa Redonda doe Parceiros dos Dosonvolvim6nto

AtTAB2 (J324)

0 Xcs

Table 3

Primary Education, Grades 1-6

School Age Population 7-12, Gross Enrollment Rates

P-riodo de Populacao am idad- Matricula ensino Taxa do escolarizacao

Ref-rencia escolar 7-12 primaxioM r TOTAL M F TOTAL Y F TOTAL

1981/82 67,495 64,045 131,540 50,075 23,546 73,621 74.2 36.8 56.0

1988/89 75,060 75,497 150,557 52,102 30,340 82,442 69.4 40.2 54.8

1990/91 79,415 77,011 156,426 54,562 29,820 84,382 68.7 38.7 53.9

1992/93 80,722 77,422 158,144 52,135 29,870 82,005 64.6 38.6 51.9

1996/97 84,749 91,113 175,862 54,519 40,536 95,055 64.3 44.5 54.1

Fonts: Minist-rio do Educacao. Anuario Estatiatico de Educacao. 1981/82 e 1992/93.

CESO - Pr-paracao da Mesa Redonda dos Parceiro- dos Demenvolvimento

A:TAB3 (JZ24)

o0

CD

Table 4

Primary Education, Grades 1-6Female Share of Enrollment by Grade/Region

1988/89 - 1992/93

TOTAL lo classe 2e classe 3. classe 4. classe 5e classe 6e classeRegions 88/89 92/93' 88/89 92/93 88/89 92/93 88/89 92/93 88/89 92/93 88/89 92/93 88/89 92/93

S.A. BISSAU 49.3 47.8 50.2 51.2 52.7 47.0 53.2 49.6 41.0 48.7 45.2 49.6 47.7 46.7

BICIBO 35.9 37.1 37.7 41.3 35.9 38.2 33.4 32.3 33.8 34.1 30.6 29.0 30.3 35.4

CACHEU 32.4 31.3 34.4 36.6 32.3 31.7 32.6 31.0 27.4 28.0 33.1 28.4 27.8 22.1

OIO 26.3 27.1 30.3 31.0 25.4 25.6 22.8 24.2 20.2 24.6 26.2 26.3 23.0 25.4

BAFATA 31.8 33.2 34.1 35.8 29.6 33.2 32.4 32.4 29.1 30.6 27.9 29.4 26.2 34.4

GABU 36.5 34.3 36.8 36.2 28.9 31.6 52.1 37.0 25.6 31.3 22.3 32.0 28.4 39.0

TOHBALI 30.1 31.0 35.6 34.2 30.9 37.3 27.5 29.0 21.0 25.3 23.7 26.2 16.9 25.0

QUINARA 30.6 31.7 33.1 34.1 30.8 28.0 30.5 36.0 25.2 28.2 27.0 27.0 21.1 36.0

BOLAHA/BIJAGOS 43.1 39.9 44.1 45.0 44.7 41.0 46.2 39.0 40.3 44.3 38.9 38.0 30.2 30.0

TOTAL 36.8 36.4 37.0 37.6 35.6 33.4 38.5 34.9 32.6 33.8 39.0 37.6 41.0 37.7

Fonts: Hiniaterio de Educacao. Anuario Estatistico. 1988/89 e 1992/93. X

A:TA.B4 (JZ24) o

Table 5APrimary Education, Grades 1-6

Internal Efficiency Indicators: Repetition, Dropout and Retention Ratesby Grade/Gander (in Percentage)

1988/1989

_ 1 2. 3. 4. 5. 6-Indicador TOTAL Class Classe Class- Classe Class. Class.

Taxa de Repetencia 37.6 44.3 42.6 33.0 37.1 18.8 16.1

Masculino 38.2 44.6 43.0 36.0 38.4 19.1 17.1Faminino 36.5 43.8 41.9 28.3 34.3 18.2 14.7

Taxa de abandono 8.2 6.6 9.9 8.2 9.0 7.4 8.7

Masculino 6.7 4.1 8.9 7.4 8.6 6.3 9.8Feninino 10.5 10.9 11.8 9.5 9.8 9.3 6.7

Taxa de Retencao 91.8 93.4 90.1 91.8 91.0 92.6 91.3

Masculino 93.3 95.9 91.1 92.6 91.4 93.7 90.2Fexinino 89.5 89.1 88.2 90.5 90.2 90.7 93.3

Taxa de aprovados 55.2 51.4 54.4 69.7 60.2 38.3 45.4

Masculino 55.3 49.3 55.6 71.9 61.8 37.7 45.1Feminino 55.0 55.1 52.3 65.9 57.0 39.4 46.0

Font.: Ministerio de Educacao. Anuario Estatistico. 1988/89. X

o i-

A:TAB5A (JZ24)co of

Table 5BPrimary Education, Grades 1-6

Internal Efficiency Indicators: Repetition, Dropout and Retention Ratesby Grade/QAnd-r

1990/1991

1e 2. 3. 4. 5. 6.Indicador TOTAL Class. % Class. 8 Class. 8 Classe % Class1 % Class. 9

Taxa do R-pet-ncia 22,745 5,838 27.2 6,469 30.8 2,036 17.8 2,752 22.4 2,566 26.6 1,542 30.2

Hasculino 14,846 3,914 28.6 4,223 31.2 1,462 19.1 1,828 25.2 1,569 25.6 925 29.3F-ninino 7,899 1,924 24.8 2,246 30.1 574 15.1 924 21.9 997 28.4 617 31.6

Taxa do abandono 9,964 3,187 14.8 2,358 10.1 1,145 9.1 758 6.2 1,344 13.9 586 11.5

Masculino 6,621 1,840 13.4 1,635 10.8 816 9.6 686 8.6 914 14.9 365 11.5Faeinino 3,343 1,347 17.3 723 8.8 329 7.9 72 1.7 430 12.3 221 11.3

Taxa de R-t ncao 79,537 18,263 85.1 20,985 89.8 11,438 90.9 11,477 93.7 8,324 86.3 4,525 88.5

Masculino 51,117 11,841 86.5 13,530 89.2 7,645 90.3 7,267 91.4 5,244 85.4 2,795 88.4Feminino 28,420 6,422 82.7 7,455 91.2 3,793 92.0 4,210 98.1 3,080 87.7 1,730 88.7

Taxa do aprovados 54,833 13,258 75.6 12,790 60.9 9,560 83.6 8,458 73.7 4,825 50.0 2,971 58.1

Hasculino 35,939 8,816 74.4 8,468 62.6 6,434 84.2 5,574 76.7 3,023 49.3 1,812 57.3Foxinino 18,894 4,442 69.2 4,322 58.0 3,126 82.4 2,884 68.5 1,802 51.3 1,159 59.4

Font.t Hinistario de Educacao. Anuario Estatistico. 1990/91.

oA:TAB5 (JZ24)

tD

-83- ANNEX II - 6

Page 7 of 28

Table 6APrimary Education, Grades 1-6

Student/School and Student/Teacher Ratios by Region1988/89

Nro. Nro. Nro. Relacaode de de

Reg$oe. Escolas Alunos Professores Alunos/E colas Alunos/Prof.

S.A. Bissau 45 21,077 708 468 30

Biombo 46 6,417 208 140 31

Cacheu 112 15,052 462 134 33

Oio 102 10,322 366 101 28

Bafata 80 8,184 290 102 28

Gabu 65 7,261 205 112 35

Tombali 81 5,914 203 73 29

Quinara 47 4,143 227 88 18

Bolama/Bijagos 40 4,072 148 102 28

TOTAL 618 82,442 2,817 133 29

Fonte: Ministerio de Educacao. Anuario Estatistico do Educacao;Mapa Educativo. 1988/1989.

A:TAB6A (JZ24)

ANNEX II - 6-84 -

Page 8 of 28

Table 6BPrimary Education, Grades 1-6

Student/School and Student/Teacher Ratios by Region1992/93

Nro. Nro. Nro. Relacaodo de de

Regioes Escolas Alunos Professores Alunou/Escolas Alunos/Prof.

S.A. Bissau 28 17,076 679 610 25

Biombo 42 8,591 251 205 34

Cacheu 103 16,277 487 158 33

Oio 105 11,385 275 108 41

Bafata 73 8,073 258 111 31

Gabu 56 6,092 193 109 32

Tombali 53 5,869 206 111 28

Quinara 52 4,261 152 82 28

Bolan-a/Bijagos 37 4,381 167 118 26

TOTAL 549 82,005 2,668 149 31

Fonts: Ministerio de Educacao. Anuario Estatistico de Educacao;Mapa Educativo. 1992/1993.

A:TAB6 (JZ24)

ANNEX II - 6

Page 9 of 28

Table 7Primary Education, Grades 1-6

Distribution of Teachers by Region/Gender1990/1991 - 1992/1993

1990/1991 1 1992/1993

R gioes M

S.A. Bissau 327 252 579 427 252 679

9iombo 171 44 215 202 49 251

Cachou 298 56 354 431 56 487

Oio 228 44 272 237 38 275

Bafata 200 44 244 212 46 258

Qabu 142 24 166 169 24 193

Tombali 183 19 202 185 21 206

Quinara 147 9 156 142 10 152

Bolama/Bijagos 90 13 103 143 24 167

TOTAL 1,786 505 2,291 2,148 520 2,668

(%) 78% 22% 100% 81% 19% 100%

Fonte: Ministerio de Educacao. Anuario Estatistico de Educacao.1990/1991 y 1992/1993.

A:TAB14 (JZ24)

ANNEX II - 6

-86- Page 10 of 28

Table 8Pre-School and Primary Education, Grades 1-6

Number of Teachers by Salary Scale1992

Categoria deIngres os Nro. de E ProfessoresMensuales Professores Sobre Total

S 125,839 1 0.0%

P 139,519 8 0.2%

N 154,136 604 15.9%

M 163,787 359 9.5%

L 172,315 250 6.6%

X 184,328 921 24.3%

J 200,375 711 18.8%

I 209,729 306 8.1%

H 256,312 238 6.3%

G 275,203 95 2.5%

F 292,534 167 4.4%

B 300,607 62 1.6%

D 309,487 39 1.0%

C 315,856 17 0.4%

B 434,081 9 0.2%

TOTAL 3,787 100.0%

Fonte: Hinisterio de Educacao. Anuario Estatistico de Educacao.Tabela de vencimento em vigor. 1992.

A:TAB8 (JZ24)

-87 -

ANNEX II - 6

Page 11 of 28

Table 9 - Guinea-Bissau: Private ContributionsShare in Education Financing

PARTICIPACION DE LOS APORTES PRIVADOS EN EL FINANCIAMIENTO EDUCACIONPESOS DE GUINEA

--------------------------------------------------------------------

I !~~~~~~ 989 1 Z DE I| NIVEL DE EDUCACION I---------------I-------------FINANCIAI

ICOSTO UNITARIO PROPJ.NA VOLUNTARIAI CION I----------------- I----…-----------------------------------…--------

IENSENANZA PRIMARIA 31,480.0 2,400.0 I 7.62 ZJENSENANZA SECUNDARIA 5 54,534.0 4,800.0 | 8.80 |

IT 0 T A L I 86,014.0 7,200.0 I 8.37 I

FTuENTE:TABLA 30 Y DIRECCION GENERAL DE ADMON Y FINANZAS

NOTA: NO HAY INFORMACION SOBRE EL PORCENTAJE DE ALUMNOS QUtE PAGAN LAPROPZNA

Note: Recent data unavailable.

Table 10

Secondary EducationSchool Age Population 13-17, Gross Enrollment Rates

Periodo de Populacao m idad- Hatricula *nsino Taxa de .scolarizacaoRef-rencia escolar 13-17 secundario

M F TOTAL M F TOTAL M FI TOTAL

1981/82 55,825 54,082 109,907 4,154 1,060 5,214 7.4 2.0 4.71988/89 61,665 60,756 122,421 3,263 1,868 5,131 5.2 3.1 4.21990/91 62,988 64,048 127,036 4,006 2,400 6,406 6.4 3.7 5.01992/93 62,630 62,874 125,504 5,277 2,630 7,907 8.4 4.2 6.31996/97 69,091 69,398 138,489 2,476 3,569 6,045 3.6 6.1 4.4

0oI00

Fonte: Minioterio de Educacao. Anuario Estatistico. 1981/82 e 1992/93.CESO - Preparacao da Mesa Redonda dos Parceiros dos Desenvolvisento

A:TAB10 (JZ24)

o, §

0

00

Table 11

Basic Secondary Education

Female Share of Enrollment by Region/Grade

1990/1991

Total 7e classe Be classe 9e classe 10. cla -se lie classe 129 classe

Regioes H F s H F M H F % M F M M F % M F % M F %

.A. Dissau 2,041 1,941 40.6 1,206 790 39.6 763 681 47.2 471 320 41.5 267 110 29.2 118 30 20.3 16 2 11.1

acheu 239 79 24.8 le 46 20.0 77 10 18.9 44 15 25.4

io 267 69 20.5 145 41 22.0 79 10 10.5 43 10 18.9

atata 269 144 34.9 156 06 35.5 77 31 28.7 36 27 42.9

abu 140 47 25.1 73 27 26.0 37 11 22.9 30 9 23.1

ombali 11 31 20.8 63 19 23.2 34 6 15.0 21 6 22.2

jinara

2lama/Bijagoa 132 09 40.3 91 58 38.9 25 23 47.9 16 0 33.3

TOTAL 4,006 2,400 37.5 1,852 1,067 36.6 1,092 788 41.9 661 403 37.9 267 110 29.2 ll 30 20.3 16 2 11.1

ntei Ninisterio do Educacao. Anuario Eatatiatico. 1990/91.

TAB11 (JZ24)

O Qo e-

I0 CY

Table 12Secondary Education

Internal Efficiency Indicators: Repetition, Dropout and Retention Ratesby Grade/Cmnder

1990/1991

7. 8e 9. 10. 11. 12.Indicador TOTAL Clasne % classI % Clans. % Clan.. % Classe % Classe 8

Taxa de Repetencia 2,090 1,142 35.5 599 31.9 290 27.3 30 7.8 29 18.2

Masculino 1,161 625 33.7 304 27.8 185 27.9 21 7.6 26 21.6Feminino 929 517 37.9 295 37.5 105 26.1 9 8.2 3 7.7

Taxa de abandono 644 360 11.2 141 7.5 122 11.5 16 4.1 3 1.9 1 5.5

Masculino 284 204 11.0 14 1.3 55 8.3 9 3.3 2 1.6 0 0.0Feminino 360 156 11.4 127 16.2 67 16.6 7 6.4 1 2.6 1 50.0 o

Taxa de Retencao 6,095 2,856 88.8 1,737 92.5 942 88.5 370 95.9 156 98.1 17 94.4

Masculino 3,749 1,648 88.9 1,078 98.7 606 91.7 267 96.7 118 98.3 16 100.0Feminino 2,346 1,208 88.6 659 83.8 336 83.4 103 93.6 38 97.4 1 50.0

Fonte: Ministerio de Educacao. Anuario Estatistico. 1990/91.

A:TAB12 (JZ24)

41-

o 4

co

- 91 - ANNEX II - 6Page 15 of 28

Table 13Basic Secondary EducationTeachers by Education Level

1990/1991 - 1992/1993

1990/1991 1 1992/1993Nivel Nro. de I Professores N Rro. de | Professores

Educativo Professores Sobre Total _

Licenciados 20 5.6% 59 13.9%

Bacharel 124 34.6% 160 37.6%

Freq. Univ. 16 4.5% 15 3.5%

lle Classe 173 48.3% 172 40.5%

9e Classe 2 0.6% 16 3.8%

Cooperantes 23 6.4% 3 0.7%

TOTAL 358 100.0% 425 100.0%

Fonte: Ninisterio de Educacao. Anuario Estatistico.1990/1991 y 1992/1993.

a:tabl3.wkl (jz24)

ANNEX II - 6- 92 -

Page 16 of 28

Table 14Basic Secondary Education

Distribution of Teachers by Region/Gender1990/1991 - 1992/1993

1990/1991 1992/1993Regio.s M F Total M F Total

S.A. Bissau 245 25 270 279 34 312

Biombo 0 0 0 12 0 12

Cachou 14 1 15 17 0 17

Oio 19 0 19 15 2 17

Bafata 18 1 19 23 0 23

Gabu 13 0 13 15 1 16

Tombali 12 0 12 11 0 11

Quinara 0 0 0 5 0 5

Bolara/Bijagos 9 1 10 12 0 12

TOTAL 330 28 358 388 37 425

(%) 92% 8% 100% 91% 9% 100%

Fonte: Ministerio de Educacao. Anuario Estatistico de Educacao.1990/1991 y 1992/1993.

A:TAB14 (JZ24)

-93. ANNEX II - 6

Page 17 of 28

Table 15 - GUINEA-BISSAU: Unit Cost by Level of EducationCurrent Prices

COSTO UTNITARIO POR CADA NIVEL DE EDUCACION PRECIOS CORRIENTES

---------------------------------------------------------- __--------------

I 1988 1 199 9| NIVEL DE EDUCACION ------------------------ ----------------------

SGB $US SGB sUS

IENSENANZA PRIMARIA I 17,963.0 11.6 I 31,480.0 13.4|ENSENANZA SECUNDARIA | 38,218.0 24-8 | 54,534.0 23.3JENSENANZA PROFESIONAL | 122,213.0 79.3 | 148,600.0 63.4JESCUELA PARA PROFERSORESI 160,358.0 104.0 I 307,040.0 130.9

IT 0 T A L 338,752.0 219.7 5 541,654.0 231.0 I

FUENTE:ANUARIO ESTADISTICO DE EDUCACION 1.988 y 1.989

$GB -Pesos de Guinea$US -Dolares Americanos

Note: Recent data unavailable.

- 94- ANNEX II - 6Table 16 - GUINEA-BISSAU: CENFI Enrollment Cours Page 18 of 28

(1990/91 and 1992/93)

secialidade Ano d Escolaridad nrollment1990/91 1992/93

A,DDrenticeshi.R Courses

Carpintaria I ano 20 202 ano 15 163 ano 13 13

Constr. Civil I ano 60 422 ano 48 483 ano 39 36

Electricidade I ano 20 212 ano 16 183 ano 12 10

Mecanica Auto I ano 20 202 ano 15 133 ano 11 13

Mecanica I ano 20 202 ano 0 103 ano 12 0

Subtotal 321 300

Trainn ore

Mecanica AutoElectricidade auto 10Manut. motores for a bordo 10Org. e gestao de oficina auto 5

ElectricidadeUtilizacao aparelhos medida 12 15

Mecanica GeralDesenho mecanico 10Afiador de ferramentas 12 --Canalizacao 16 15

Frio e climatizacao - 15

Pedreiro - 15

Soldadores - 15

Refregiracao - 15

Carpinteria - 15

ANNEX II - 6- 95 -

Page 19 of 28

1990/91 1992/93

Education courses

Mecanica AutoElectricidade auto 20 -

ElectricidadeInstalacao industrial 20 -

Manutencao electrica 20 -

Motores electricos 20 -

Mecanica geralTorneiro mecanico 20 -

-- = not available

Fonte: Ministerio de Educacao, Anuario Estatistico. 1990/91 - 1992/93.

a:tabl6 (z24)

- 96 - ANNEX II - 6

Table 17 - GUINEA-BISSAU: CENFA Enrollment Page 20 of 28(1988/89, 1990/91, and 1992/93)

Anos LectivosEspecialidadg Level 1988189 1990l91 1992/91

Intensive courses

Dactilografia 84 66 66Contabilidade base 0 104 103Gestao financeira 0 26 32Gestao tesouraria 24 0 0Pratica de Secretariado 0 26 59Estaistica 15 0 0

Total 171 222 260

Intermediate courses

Contabilidade curso medio 1 ano 75 282 ano 22 253 ano 12 22

Economia I ano 0 302 ano 0 03ano 0 0

Total 109 105 198

Prol crse

Administracao 1 ano 20Publica 2 ano 17

Secretariado 1 ano 242 ano 21

Total 0 82

-- = not available.

Fonte: Ministerio de Educacao, Anuario Estatistico. 1988/89, 1990/91, and 1992/93.

tabl7 az24)

-97- ANNEX II - 6

Table 18 - GUINEA-BISSAU: CEFC and CEFAC Enrollment Page 21 of 28(1988/89 and 1992/93)

.1988/89 1992/93Especialidade h oa

ZEF-C

Dactilografia 13 12 25 - - --

:ontabilidade base 7 0 7 37 0 374ecanica auto 8 0 8 - - --

slanut. pequen. avarias 8 0 8 - - --\4ecanico bicicletas 12 0 12 11 0 11Votor fora bordo 12 0 12 18 0 18Ferreiro 15 0 15 16 0 16-onstrucao civil 9 0 9 - - --

knimacao feminina 0 16 16 - - --

Carpintaria 6 0 6 - - --

klfabetizacao 254 194 448 - - --Costura - - - 0 20 20Producao de sabao - - - 130 130Horticultura - - - 30 30Formacao debase - - - 199 0 199

rotal CEFC 344 222 566 281 180 461

CEFAa

Carpintaria 24 0 24 25 0 25Mecanica agricola 17 3 20 - - --Agricultura geral 40 14 54 0 320 320

Total CEFAG 81 17 98 25 320 345

-- = not available.

Fonte: Ministerio de Educacao, Anuario Estatistico. 1988/89 and 1992/93.

tabl8 (jz24)

-98 -

ANNEX II - 6

PaRe 22 of 28

Table 19 - GUINEA-BISSAU: Allocation of Education Operating Budget/Levels of Education

DISTRIBUTION DEL PRESUPUESTO DE FUNCIONAMIENTO EN EDUCATIONSEGUN DESTINACION A LOS NIVELES DE EDUCACION

2 PART. Z PART. Z PART. Z PART.NIVELES DE EDUCACION 1980* 1983* 1988* 1989*

ENSENANZA PRIMARIA 76.0 67.0 48.9 54.3ENSENANZA SECUNDARIA 15.0 15.0 10.0 11.4FORMACION PROFESIONAL 3.1 3.8INSTITUTO AMIZANDE 6.1 5.0EDUCACION SUPERIOR (1) 1.0 2.0 1.9 1.7OTROS 8.0 16.0 30.0 23.8

T 0 T A L 100.0 100.0 100.0 100.0

FUENTE: ANUARIO ESTADISTICO DE EDUCACION 1988 Y 1989*BANCO MUNDIAL, ESTUDIO DE POLITICA GENERAL: LA EDUCACION ENAFRICA SUBSAARIANA, 1990

(1) ESCUELA DE DERECHO Y ESCUELA PARA LA FORMACION DEPROFESORES DE SECUNDARIA

CULtu DATURA'; §-X.ti,g

CONSELNO polRtCTIO .

4 LS X* ~~~~~~~~~~~~~~~~~~E PR EttiA02

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Figure 2 - GUINEA-BISSAU: Primary School 1992/1993Female/Male EnrollmentAges 7-12, Grades 1-6

School Age Females: 77,422 School Age Males: 80,722

__ ~~~~~~~~~~~~~~~~out-of -_School,_

Enrolled, 38.6% 35.4%

Out-of -School, Enrolled,61.4%646

o tTl

x

0 '-

1-1 IN)C

ANNEX I - 6

Figure 3 - GUINEA-BISSAU: Primary School 1992/1993 Page 25 of 28Distribution of Teachersby Gender and Region

450 -427 431

400

350 -

300I- 250 52 237 UMale

200 20I22 169 185 FII Female

150 142 143

,100 5

50 ~" 38 46e 24 21 10 24

00 0<

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I- 0 CORegions

Figure 4 - GUINEA-BISSAU: Secondary School 1992/1993Female/Male EnrollmentAges 13-17, Grades 7-11

School Age Females: 62,874 School Age Mes: 62,630

Enrolled, 4.2% Enrolled,6.3%

Out-of-School, Out-of-95.8% School,

93.7%

H0

co

- 103- ANNEX II - 6

Figure 5 - GUINEA-BISSAU: Secondary School 1992/1993 Page 27 of 28Distribution of Teachersby Gender and Region

300 --278

250-

1200 EMaleI.-

~~~~ 150 ~~~~~~~~~~~~~~~~Female

100

z-150 34 12 17 _ 23 O0 12

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Rogkma

- 104-ANNEX rI - 6Page 28 of 28

Figure 6 - GUINEA-BISSAU: STRUCTURE OF THE EDUCATION SYSTEM1990

General Education Secondary Education Higher Education

Secondary

Pescrool Elementary & Com plem General ComrDlemMedical Scnool

12 13 14 S 811 1 1 13 58

Law Scrool

Teacners Training

Agriculture 'z

7Teacners Basic Education

Nursing LJ

_0 2

ENEFD (Com munity Training)

CENFlI (ndustrial Training)

_- 2

- 105 -

ANNEXES FOR

THE STATUS OF WOMEN IN GUINEAN SOCIETY

- 106-

- 107 -ANNEX III-1Page 1 of 8

GUINEA-BISSAU

WOMEN'S STATUS AND ROLE IN GUINEAN SOCIETY

A. OVERVIEW OF THE SOCIETY

1. Most of the ethnic groups in Guinea-Bissau are structured horizontally, which seemingly isindicative of an integration and equality of all members of society. Also, men and women struggledtogether for the country's independence, which would also seem to indicate a greater participatoryrole for women in the country's social and economic development. These factors, nevertheless, beliethe true situation regarding the status of women in Guinea-Bissau. For the great majority of women,the traditional socio-economic structure of gender differences has remained largely unchanged, withno significant improvement in the status and lives of women. The country's economic situation hasprogressively put a strain on the population, and Guinean women have been especially vulnerable tothe conditions of extreme poverty that have prevailed. When economic impoverishment is added tothe deep-rooted traditional and cultural practices, women become the most disadvantaged members ofsociety and, for the most part, are left out of the mainstream and have very limited access to basicsocial services or to productive resources that would enable them to engage in income-generatingactivities. The high female illiteracy rate of over 80% is indicative of disparities in access to formaleducation and the low value assigned to the education of girls. It is not unusual for girls in ruralareas to be married between age 13 and 15, with some marrying at an earlier age. The early age ofmarriage contributes to the high fertility rate: women have, on average, six or more children. Infantmortality (140 per 1,000 live births) and maternal mortality (8 per 1,000 live births) are among thehighest in the Sahel. Life expectancy for women is estimated at 44 to 48 years.

2. Traditional influences. For most of Guinean society, in which the Westernized urbanpopulation is only a minority, the traditional organizations, which are generally patriarchal andcentered around male elders, mystic beliefs, and a system of symbolic and analogical thought, are thetrue realities. Subsistence farming, the predominant activity, is governed by the changing seasons.The fundamental stages of life-birth, passage into adulthood, marriage and death-are all marked byreligious ceremonies. Problems in daily family and community life are resolved through rituals andsacrifices. The traditional living system characterizing Guinean society and defining it in its mostoriginal aspects exerts a very strong influence on all areas of intervention within the community,particularly on women's lives. The restrictions placed on women, the authority of the clan's chief,the importance of religion, the organization of agricultural work, nutritional and sexual taboos,associations and age groups, traditional channels of information and communication, limitations tobasic scientific knowledge, and analogical thought combined with the high value given to traditionalknowledge-these are all examples of the complexity of the rural culture and life style into which anydevelopment action must be integrated if it is to have a lasting impact.

B. PROFILE OF GUINEAN WOMEN

1. Legal Status

3. Local customs and the legislation inherited from the colonial period still largely govern thelives of women. Some new measures, modeled after the supplementary laws of the PortugueseFamily Code, have been introduced in an effort to adapt legislation to the Guinean situation. For

- 108 -

ANNEX II-1Page 2 of 8

example, the law that distinguishes legitimate form illegitimate unions ratifies those unions that havelasted at least three years. Furthermore, all children born either in marriage or out of wedlock areconsidered legitimate merely by the father's affiliation. The Government plans to enact reformlegislation specifically related to the family.

4. In Guinea-Bissau there are some contradictions between traditional or customary law andmodern law. Despite applicable legal provisions in modern law, it is traditional or customary lawthat takes precedence when it comes to matters related to inheritance. Land and natural resources areowned by the State. Women do no inherit land or assets, and have indirect access to land throughtheir relationship with men. The fact that the Constitution does not provide for specialized courtspartially accounts for the nonexistence of a special court concerned with labor law; consequently,labor conflicts are handled by the civil courts. General labor legislation, in theory, calls for equalitybetween men and women, and salaries and wages are supposed to be established on the basis of"equal work, equal pay." Nevertheless, with their inferior education and skill training and hamperedby cultural restrictions women are disadvantaged in their ability to compete with men in the laborforce.

5. Guinean women are entitled to vote and be elected to public office. A number of women aremembers of the National Assembly (about 20% of the 1985 assembly members). Women also holdresponsible positions in the Government. Three hold ministerial portfolios: the Minister of Women'sAffairs, the Minister of Public Health, and the Minister of Social Affairs.

6. The minimum age of marriage for women is set at 18, which is higher than the legal age inmost of the other sub-Saharan countries. However, except for urban environment, where marriageoccurs relatively late, a large proportion of the population are either unaware of or choose to ignorethis law. According to a survey conducted in Gabu in 1981, when queried about the appropriate ageof marriage for women, most of the interviewees said that it should be between age 13 and 15.About 68% of all marrying women are 14 to 16 years old. This practice of early marriage is a majordeterrent to post-primary education for girls. While polygamy is not officially recognized in Guinea-Bissau and only monogamous marriages are legal, polygamy is widespread, mainly in the rural andMoslem environments. According to the same survey, 47% of husbands interviewed indicated thatthey wanted to be polygamous in order to have many children

7. There are o legal provisions that deal specifically with family planning. While under the codeof penal procedure abortion is prohibited (unlike in most of the other countries in the region), it istolerated in practice and in the hospitals.

2. The Socio-Cultural Context

8. Ethnic pluralism in Guinea-Bissau has created a polyglot society, with each ethnic grouphaving its own traditions and beliefs. The most important groups are the Balantas, representing 27%of the population, followed by the Fula (23%), and the Papels, Manjiacas and Brames (22%). Interms of religion and its influence on culture and customs, Islam, animism and the tradition ofpolygamy are widely practiced. Islam is the religion of about 35% of the population, and a largemajority of Islamic girls are subjected to the traditional ritual of circumcision as well as earlymarriage; as an example, the Fula women are circumcised only once, whereas the Beafada womenundergo the ritual twice by the time they are nine years old.

-109-

ANNEX III-1Page 3 of 8

9. Guinean society comprises various types of family structure, with polygamy the mostprevalent. Within the same village, different types of polygamous linearship may coexist. In BiomboRegion, the Papels practice a matriarchal system, while the Balanta's system is patriarchal; however,in both of these groups women cannot inherit land or other assets and they have only indirect accessto land through their relationship with a man. Because women lack collateral, they have no access tocredit and this severely reduces their income-generating potential. Even though men control the land,women still have access to the fields through their husband and can use them to cultivate crops forfamily consumption or for selling at the marketplace. Also, the collective labor tools (e.g.,wheelbarrows and ploughs) are owned by men, who determine the place and time of their utilizationand their allocation among the productive members of the group. In essence, the strongpredominance of cultural traditions constitutes a major constraint to the country's socio-economicdevelopment. Women have neither control of inputs nor use of the income resulting from their labor,yet they retain customary responsibility for child-rearing and the welfare of the family. Because ofchanges in the economic environment, women, out of necessity, have begun to engage in botheconomic activities in an outside the home in order to achieve self-sufficiency. They workconsiderably longer hours than do men (an average of 14 compared to 8); men mostly performseasonal farming activities.j/

10. Rural areas. In the rural areas women are responsible for cultivating rice and other foodcrops and for fishing, preparing meals, and fetching water and fuelwood. The normal day of a Papelwoman, for example, starts at sunrise or even earlier when the fields need watering. Her quest forwood can last hours. She must then beat rice in a pestle and use it to prepare the family's main mealusually served in the mid-afternoon. She then cleans up, gets water, collects salt, and waters thefields, while other women smoke fish or make soap. 2/ The division of agricultural labor betweenthe genders depends on the region, tribal custom, and the crop-mix. Among some ethnic groups,such as the Manjiacas, women work in large groups and alternate tasks, while in others women workalone or the tasks are distributed according to age. In general, men are responsible for clearing theland and for cash-crop production, while women take care of sowing and weeding the fields,collecting and piling the crops cut by men, husking the rice, and carrying the produce to market.However, droughts and difficult economic conditions have led to an out=migration of men from ruralto urban areas, and have also induced changes in women's economic roles; for example, thecultivation of groundnuts, one of the country's main export crops, is now performed mainly bywomen. In contrast, some men are now involved in more lucrative activities that previously wereconsidered to be 'women's work' (e.g., growing fruit and rice), in order to earn money.

11. Women in rural areas are married at a young age, and then join their husband's family. Afew ethnic groups allow women to choose their own spouse, parents' motivation to invest in theirdaughter's education and welfare might be lower than in the case of their sons. However, it isgenerally recognized that women make the important decisions regarding birthspacing, nutrition andthe education of children of primary school age. They are also active at the grassroots level inorganizing basic health care, day care and extension services. In Oio Region, for example, womenhave organized themselves to delegate some of their over-burdening household tasks to a day care

j/"Contribution a la connaissance de la situation socio-economique de la femme en Guinea-Bissau, D. Lima Handem et R. Mendes Fernandes, Janvier, 1988.

Z/Preparation study on the productive activities of women in Biombo, S.N.V. Sep 1988.

110 -

ANNEX II-1Page 4 of 8

center while they perform agricultural activities. UNICEF has financed a pre-school component forage 2-7 years under the Integrated Rural Development Project.

12. Urban and peri-urban areas. In the urban and peri-urban areas, traditions and customs are notas predominant and controlling as they are in rural areas. However, even in towns and cities,customary laws on inheritance and marriage exert some influence. In urban environments, womenwork mostly in small businesses, paid labor, or in the Government.

3. The Socio-Economic Context

13. As a result of a recent trade and price liberalization, the prices of production factors andconsumption goods (particularly food) have increased, contributing to changes in productive roles.More women are now engaged in agricultural, food-processing and artisan activities both in anoutside the home, either to enhance family income or as a necessity to survive. The urban and peri-urban areas have been particularly hard hit by the price escalations in consumption products, sincesalaries have not kept pace with the rate of inflation. As an illustration, since the devaluation of theGuinean peso in 1984 the official price of rice in 1989 reached a level exceeding by 24 times the1984 level. However, on the market rice, the country's main staple food, was sold at 120 times the1984 price in 1989. This sharp difference between the official and market price is largely attributableto the limited number of importers and wholesalers, which artificially creates scarcity of certain times.In comparison, salaries, increased only by 5.3 times during this same period. I/

14. In Bissau, 92% of the civil servants earned a nominal wage of less than GP 27,500 in 1987.The typical family of a civil servant has about six members. A family headed by a female cleaninglady, earning a gross salary of GP 10,200, certainly faces difficulties in feeding her dependents,particularly if the price of a kilo of rice costs 250 pesos, a liter of oil 1,200 pesos and a kilo ofinferior quality fish GP 300. A family of six consumes an average of 50 kilos of rice per month,which in 1987 cost GP 12,500.4/

15. Women's role in production. While the demographic balance of women equals that of men,according to official statistics their participation in the country's economic life is limited to about 3%of the employed active population. Nevertheless, women aged 15 to 54, who were regarded as"inactive' for the purpose of the 1979 census, probably represent more than 45% of the total activepopulation. A woman's role as a producer depends on whether she lives in a town or in thecountryside. Women in rural areas play a predominant role in agricultural production, while in urbanareas their participation in the economy concentrated in the services/autonomous sub-sector. Thewage-earning population includes few women, and they are mainly in the civil service. Commerce,hotels and restaurants, transportation, and domestic service comprise other areas of employment forwomen.

I/ S.N.V. 'Women in Guinea-Bissau", 1989

A/"Analyses de la Situation des Enfants et des Femes en Guinea-Bissau," UNICEF, October1988.

r- 111 -


16. Informal se . Approximately 80% of Guinea-Bissau's population reside in rural areas. Itis estimated that women constitute at least 55% of the active agricultural labor force between age 15to 54 years JI. They are largely involved in highly labor-intensive and physically exhaustingoccupations, such as horticulture and food-crop production. In the past, women received few benefitsfrom the extension services since these services were directed mainly to the cash-crop sector. Onlyrecently have women benefitted from improved technologies and seeds, through the introduction oftechnical assistance projects financed by local non-governmental and international donororganizations. For example, the Greenbelt Project, financed by FAI, focuses on women's concernsby improving their efficiency in agricultural production, such as growing tomatoes and vegetables.Currently, about 2,500 women are involved in cultivating community gardens around the Bissau areaand the number is increasing; 150 hectares are under cultivation, for a ratio of about 600 squaremeters per woman. The Greenbelt Project is considered to be of great importance in food security,since it impacts on the subsistence of a population group highly vulnerable to periodic increases infood prices.

17. In industry transformation and the service areas, the 'monetary informal sector' is asignificant employer, providing income for a large number of female workers. In the coastal areas,the Papel, Manjiacas and Bijagos women are engaged in various artisanal activities involving theprocessing of fish and mineral products, including the extraction of sea salt, making soap andhandicrafts. In addition to agricultural and artisanal occupations, women in rural areas are involvedin fishing and livestock production, mainly for family consumption. In urban areas, trade is one oftheir most important income-generating activities. Women are especially active in trading food(vegetables, fruit, bread, salt and palm oil), seafood, poultry, and manufactured goods (soap,clothing). In general, the revenue earned is spent on clothing and school materials for the children,medications, and kitchen utensils. Additional resources are used to cover the costs of religiousceremonies -sacrifices, marriages, circumcisions, and funerals.

18. A recent survey of the informal sector, conducted under the Social and Infrastructure ReliefProject (SIRP), shows that of 605 micro-enterprise operators interviewed, 10% of the entrepreneurs inthe Bissau area are women. A seminar jointly organized by the World Bank and the NationalInstitute of Research and Studies (INEP) was scheduled for early 1991. This seminar was to focus onidentifying problems faced by small enterprises. Institutional, economic and social aspects andwomen's concerns were also to be given special consideration.

19. Formal sector. Women's contributions to the economy are under-valued and the constraintsthey face underestimated, because they are "invisible" in national and regional statistics. Theirparticipation in the formal sector accounts for only 3.6%, as shown in the Table below. The totalshown for active women (7,594) seems extremely low when to the country's total female population(409,288), representing only 1.9%.

5/"Agricultural Census of 1988", Ministry for Rural Development and Agriculture.

- 112 -ANNEX II-1Page 6 of 8

Table 1: Active Population by Gender(Based on data from 1979 census)

Total Men % Women %

Total 213,010 205,416 96.4 7,594 3.6Employed 191,424 185,102 96.7 6,322 3.3Unemployed 21,586 20,314 94.1 1,272 6.9

Source: Ministry of Planning and Cooperation, October 1990.

20. Formal employment by economic sector and gender, based on the latest official data, is shownin the table below. The distribution of employed women among the sectors varies from 1.7% in theprimary sector (mainly agricultural activities) and 6.5% in the secondary sector (manufacturing andindustries), to 9.8% in the tertiary sector (non-manufacturing and banking services). Only in thebanking and financial institutions and in the services is women's participation significant-26.8% and10.7%, respectively.

- 113 -


Table 2: Structure of Formal Employment by Sector and Gender(Based on data from 1979 census)

Employed Population

Sectoral Activities Total % Men % Women %

PRIMARY SECTOR 152,976 100.0 150,271 98.3 2,795 1.7

Agriculture, Fishery,Livestock, Forestry 152,968 100.0 150,263 98.2 2,705 1.8

Mining Industries 8 100.0 8 100.0

SECONDARY SECTOR 4,812 100.0 4,497 93.5 315 6.5

Manufacturing 2,894 100.0 2,616 90.6 278 9.4

Energy, Electricity,Water 268 100.0 254 94.8 14 5.2

Construction andPublic Works 1,650 100.0 1,627 98.7 23 1.3

TERTLARY SECTOR 33,631 100.0 20,330 90.2 3,301 9.8

Trade 5,054 100.0 4,727 93.6 327 6.4

Transportation andCommunications 2,358 100.0 2,220 96.2 138 5.8

Banking and FinancialInstitutions 205 100.0 150 73.2 55 26.8

Services 26,014 100.0 23,233 89.3 2,781 10.7

OTHERS 5 100.0 4 80.0 1 20.0

TOTAL 191,424 100.0 185,102 96.7 6,322 3.3

Source: UNICEF. Analyses de la situation des enfants et des femmes en Guinee-Bissau. Octobre1988.

- 114 -ANNEX EI-Page 8 of 8

21. As a general rule, working women are under-qualified and therefore occupy thelowest ranks of the socio-occupational and administrative hierarchy. Because of their low educationallevel, most women occupy mainly lower-paying positions (e.g. in nursing and teaching, and as officeworkers). and perform laundry and ironing work. Examples of the typical positions occupied bywomen are shown in Table 3 below.

Table 3: Positions Predominantly Occupied by Women(Based on data from 1979 census)

Total Men Women Women %

Nurses 945 566 379 40.1

Teachers 2,716 2,057 659 24.2

Secretaries 349 194 155 44.4

Laundress 137 20 117 85.4

Total 6/ 213,010 205,416 7,594 3.5

Sour: Analyses de la Situation des Enfants et des Femmes en Guinea-Bissau, UNICEF, October1988.

22. At the Government level, in October 1990 three Ministries out of 23, were headed bywomen. With respect to other high professional levels, 14% of the people's court judges werewomen and 18% of the all civil service positions are held by women. Within the political party,PAIGC (African Party for the Independence of Guinea-Bissau and Cape Verde) women are widelyrepresented at both the regional and state levels. PAIGC was founded in 1956 to liberate the countryfrom Portuguese domination and to promote social and economic growth, especially throughreduction of the high illiteracy rate. Even in the supreme body of the political structure--the People'sNational Assembly, where all laws are debated, proposed and amended-women exert considerableinfluence. Many well-educated Guinean women hold several high level positions simultaneously; forexample, the Minister of Women's Affairs is also in charge of external relations for PAIGC.

c:annexiii-l.gub (mr)

§/The difference between the totals of Table 2 and 3 are due to the exclusion of unemployedsegments of the population, which is approximately 10% based on the latest 1979 census data.

- 115 -ANNEX m-2Page 1 of 3

GUINEA-BISSAU

INSTITUTIONAL FRAMEWORK FOR WOMEN'S AFFAIRS

Ministry of Women's Affairs

1. The Ministry of Women's Affairs (MWA) was created in March 1990 to addresswomen's issues at the national level. In October 1990 the Ministry had a full-time staff of 17,including the Minister, and comprised five functional units: (a) the Studies Office, (b) theMinister's Cabinet, (c) the Information Center, (d) the Services Department, and (e) the FinanceDepartment. The MWA budget for 1990 was GP 100 million, of which investments accountedfor only about 10%. In late 1990 the Ministry was supervising 15 multi-sectoral projectsinvolving women; these projects are largely dependent on external assistance.

2. The Ministry collaborates with the Democratic Union of Women (UDEMU),established in 1961 by Amilcar Cabral as part of the country's early political system prior toindependence. UDEMU's original objectives were to enhance awareness of the roles of womenand to coordinate women's activities in the eight regions. It continues to maintain these objectivesand, because of decentralization, its activities are being integrated with many of MWA's. Inessence, the Ministry has assumed responsibility for UNDEMA's programs. The two institutionscomplement each other and use each other's staff and other resources; for example, the Ministerof Women's Affairs also serves as the Secretary General of UDEMU. UDEMU organized twonational seminars in 1982 nd in 1988 that focused on the importance of women in Guineansociety. The organization has launched several integrated development projects in rural as well asurban and peri-urban areas, such as the Integrated Development Project for Women in Bissau,financed mainly by UNFPA. That project has been taken over by MWA; it consists of training22 'animators' (rural trainers) in areas such as horticulture, nutrition and husbandry, andpromoting these activities at the village level. Women are encouraged to participate and helpdisseminate the acquired skills and information.

3. Since its establishment MWA has conducted a campaign against the circumcision ofgirls, as well as providing support for other initiatives such as the establishment of communitycredit services, first undertaken by UDEMU. However, even though Guinea-Bissau now has aninstitutional capacity specifically aimed at addressing women's concerns, the technical andfinancial resources needed to implement programs are lacking. Also, there are insufficientgender-specific data that can be readily accessed to guide the planning and implementation ofprograms.

Recommendation

4. The Ministry of Women's Affairs in collaboration with other Ministries, shouldundertake the formulation of a comprehensive strategy for improving the status of women andbringing the WID perspective into all activities concerned with the country's socio-economicdevelopment. For example, MWA could collaborate with the Ministries of Education and Healthto educate women in adopting better hygienic and nutritional practices. Also, the Ministries ofEducation and Labor could collaborate in designing programs to improve the linkage betweentraining and employment skills and to help open up better-paying job opportunities for women.

- 116 -


5. Other policy measures could include reviewing ongoing projects in the context ofWID issues and developing action programs; designing a system that would facilitate women'saccess to credit; and devising the constitutional and legislative rules and procedures with respectto women's rights (i.e., marriage, inheritance). The Government could collaborate with UNDP'sproject proposals for policies and strategies that integrate women into development programs, andproviding the Ministry of Women's Affairs with technical and financial assistance.

6. The Government could assist MWA in attaining its initial goals which include:

(a) organization and follow-up of an international seminar on establishing a WestAfrican Economic Community, in order to develop an integrated WID strategy at theregional levels for improving the status of women;

(b) reorientation of the technical and vocational education programs to expand trainingopportunities for women in civil and agricultural engineering and in businessmanagement;

(c) implementation of a survey to assess all aspects of the condition of women andchildren in Guinea-Bissau; and

(d) establishment of a counseling service to make available to women legal advice inmatters of concern to them, e.g., employment, marriage, inheritance and businessenterprises.

7. The Government could actively participate in identifying small-scale projects thatinvolve women in the areas of primary health care and family planning, and also in education, tostimulate grassroots-level activities supported by NGOs.

8. The Ministry of Women's Affairs should initiate an effort to establish a coherentinformation system within the various ministries in order to build a record of gender-specific datain the various sectors and to coordinate and standardize data collection. Current and reliableinformation is a prerequisite for designing viable new development programs that take intoaccount women's needs and concerns. Much of the existing statistics show inconsistencies thatcannot be reconciled.

GUINEA BISSAUTINISTRY OF WOMEN'S AFFAIRS

udies OfficeauralIRIources GenerF

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wI "

- 118-

- 119-ANNEX mR-3Page 1 of 6

GUINEA- BISSAU

LOCAL CONSULTANTS' REPORTS

The reports set out below summarize an inter-ministerial consensus on the need to addressWomen-In-Development (WID) issues. The first re provides a general description of theintegration of women in the country's overall development process; the scnd report gives anoverview of the status of women by the Ministry of Planning and Cooperation; the third repr relatesto the linkage between WID projects and the intervention of NGOs; and the fourth rep is a draftletter addressed to the President of Nigeria, written by the Minister of International Cooperation, togain international support for WID programs.

I. INTEGRATION OF WOMEN IN THE COUNTRY'S OVERALL DEVELOPMENT PROCESS

The promotion of Guinean women in the socio-economic and cultural development of thesociety, presumes the implementation of multi-dimensional structural changes affecting theirmainstreaming into the Guinean development process. Recently, women have been playing anincreasingly important role in the country's socio-economic growth path.

In fact, it has been observed that the participation of women in the socio-economicdevelopment has become a reality. Women are involved not only at the lower levels of the politicalstructure, but also occupy important positions both at the regional and national level. Even at thesupreme body of the state 'the People's Assembly", where all laws are debated, proposed andamended, women are present. At the judiciary level, 14% of the people's courts judges are women,however their participation in the Council's speech is minimal. In Public Administration, 18% of allcivil servants are females, most of them are concentrated in the health and education sectors. At theDirector's levels, their situation is disadvantaged due to lack of academic and literature training.Within the Government only very few women are registered.

In the economic sector, the woman's role is essential. Her contributions are underestimatedbecause the official statistics exclude females' activities, regardless of whether they are classified asdomestic or productive. Nevertheless, women actively participate in the rural economy. The multi-ethnicity which characterizes the Guinean society does not acknowledge women's participation in theagricultural production. The labor division between the two genders determines the type ofcultivation and production of agricultural products. Generally speaking, women work alone or withteenagers and take care of sowing, storing grains, and transporting the produced crops to the markets.They collect and pile the crops cut by their men. These activities are physically exhausting anddamage their health: women often complain about head- and backaches. Despite all these laborintensive tasks, females have no access to land or tools.

However, women's activities are not limited to agriculture, but they also participate in otherareas such as fishing and animal husbandry. In addition, they contribute to the formal sector throughoccupations in commercial and industrial businesses, public services, and various service orientedsectors. To conclude, one cannot speak about development without referring to: (a) economy, (b)health, (c) education, and (d) culture. In the economic sector, women are considered "invisible",

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however, 79.3% of the active female population is employed in this sector. In the education sector,women's participation is crucial for the future growth of the country. In the health sector, womenoccupy the majority of the administrative and nursing positions. Hence, in reality, women have beeninvolved in cross-sectoral employment opportunities touching the political, economic and socialaspects of life.

Therefore, given the present stage of development, UDEMU continues to pave the way tointegrate the Guinean women in the economic development and is unconditionally assisted by thepolitical party PAIGC. For this reason, UDEMU has organized itself to achieve the followingobjectives:

- Mobilize females to improve their integration in the political organization of thecountry, to promote equality between genders;

Create conditions enabling women to free themselves from domestic chores;

- Increase female's participation in education;

- Develop a political framework conducive to the elimination of customs jeopardizingthe integration of the Guinean women in society;

- Create conditions promoting equal rights between males and females in the economicenvironment.

II. OVERVIEW ON STATUS OF WOMEN

Guinea-Bissau is classified by the United Nations as a Less Developed Country (LDC). Theformulation of a new economic policy is based on the development of a macro-economic adjustmentstrategy, and is in itself a positive indicator of development. Nevertheless, the country's social andeconomic indicators are alarming.

In this context, women play an increasingly important role. They not only claim equalitybetween genders in society, because of political and ideological reasons, but women in rural areasacknowledge the large participation of women in the economy. Although, the official statistics do notformally account for the economic role of women, they largely contribute to the agricultural andartisanal production.

Since, the implementation of the new macro-economic policies that lead to the liberalization ofthe economy as a measure of adjustment, women have started to outmigrate from the rural to theurban areas. Women have played an important role in the national economy. Through theirparticipation in several projects, they have been largely involved in the following activities:production of agricultural products, food consumption, goods and handicrafts. These projects are forexample the three-phased Rural Integrated Development Project (PDRI), the salt extraction, palm oil,soap manufacturing, ceramics, rice picking, commercial enterprises, public services, fishery andseafood, harvesting of agricultural products for family consumption, health and education projects.

Great effort has been made by the political party and the Government to integrate the womenin the economic development, particularly through the intervention actions of UDEMU; UDEMU haslaunched two quadrennial plans: one covers the period of 1983/86, and the other 1989/92. Both have

- 121 -ANNEX m-3Page 3 of 6

been focusing on improving the education of women in the agricultural sector an in promotingintegrated development projects. One example is the Greenbelt project, which promotes thecultivation of community gardens by women in the Bissau area. Its objective is to make women moreself-sufficient and less vulnerable to price fluctuations of consumer goods. Women activelyparticipate in the production, transformation and marketing of the products.

A. Structure of the Employed Population

History has pointed out that women have had multi-dimensional responsibilities in theeconomic, political, social and cultural environment of the society. However, the formal statisticsindicate that only 3.6% of women are active. In reality, 83.2% of women are employed across thevarious economic sectors. The number of active females (7,594) seems extremely low compared tothe total female population (409,288), representing only 1.9%.

Women are represented at all activity levels: 14% of the people's court judges are females,2.5% are workers, 26.5% occupy scientific and technical professions (mainly in the health andeducation sectors), 20.3% hold positions classified as "traditional", including typewriting,housekeeping, and performing laundry and ironing duties. Thus, despite the difficult socio-economicsituation in the country, multi-sectoral opportunities have been created for the Guinean women.

B. Women-In-Develoment Projects

In the context of proposed programs formulated during the second meeting of UDEMU,general guidelines have been developed to integrate WID. Particularly through the "integratedprojects", these programs and policies have become reality. These projects usually comprise multiplecomponents addressing women's issues such as illiteracy, extension services, agricultural productionand marketing, and profit generating activities. Below is a list of the different projects involvingwomen, regardless of the manager's gender:

- Cultivation of cereals in Quebo, internal financing (FND);

- Integrated Development Project de Quinara, Bolama/Bijagos, Zone I, Boe andCabuxanque, financed by Germany, COE, ASDI, EC, PNUD, PNUAP, UNIFEMand FND;

- Small-scale fishery in Quinara/Tombali financed by the Dutch, FAO and FND;

- Maintenance of wells in the rural areas financed by the Dutch and FND;

- Education on the use of combustibles (wood and coal) financed by France and FND;

- Family Planning financed by FNUAP and FND;

- Development of Maternal-Child Health care financed by the Italians and FND;

- Integrated Rural Development Project for women financed by UNDP and FND;

- Associations and women cooperatives.

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m. STATUS ON THE INTEGRATION OF WOMEN-IN-DEVELOPMENT PROJECTSSUPPORTED BY NON-GOVERNMENTAL ORGANIZATIONS

Since the declaration of independence, Non-Governmental Organizations (NGOs) haveincreasingly being supporting micro-level activities, which were previously undertaken by traditionalassociation groupings. On many occasions women have been the primary beneficiaries. SOLIDAMIhas collaborated with associations and NGOs on the development of integrated project focusing onwomen, such as:

Associations: The Fruit Culture Association of Saint-Jean/Bolama includes 76women, and the Tomato Processing Co., involves 80 women and the number is stillincreasing. The women's group of Cupilom "Haffia", comprises seven women inpainting, weaving, and basket making activities. The bakery of "Saco Vaz", inCanchungo includes 25 women. In the soap manufactory of Pelunchungo, the palmoil factory of Caio and Cadjecute, as well as in the ceramics factory of Calequissemost workers are females.

- Q.Da: The "Greenbelt' project, which is active in 14 different locations in theBissau area, involves approximately 2,500 women. The horticulture project ofwomen in rural areas: Prabis, Cumura, Pefine and Naque, groups as many as 80women.

Ministry of Agriculture

ontext. Guinea-Bissau is a small country and occupies 36,125 square km. with over900,000 inhabitants. Women represent over 51 percent of the population, and more than 80 percentlives in the rural areas. These facts reveal the importance of women in the country's economy, andthe predominance of agriculture in the national economy. Women participate in all different stages ofthe agricultural activities: production, transformation and processing.

Traditional System of Cultivation. In Guinea-Bissau there exists a sexual division of laborbased on ethnic groups, agricultural regions, and type of culture practiced. For example, it has beenobserved that in the South, the rice producing area in the country, women are in charge of sowing,bedding, pestling, transporting and storing the rice. They are also involved in the cultivation andmarketing of groundnut and cassava, and are occupied with fishing activities during the year. Onmany occasions, women participate in men's agricultural tasks, and thus, both genders complementthe family's economy. In the peri-urban areas, women ensure the provision of regular and diversifiedvegetables to Bissau.

Control and Access of Land. Land tenure is decided upon by the chief of the ethnic group.However, women are in charge of organizing the labor distribution in the fields, which were allocatedto them under customary law. Women work alone and are assisted by their daughters, or exchangefemale labor among different groups, particularly during rice harvesting time. They prepare themeals using their own resources and pay for the input factors to cultivate the land.

apital. Women own few tools and only until recently, have they benefitted from extensionservices. With the help of modern equipment (wheel-barrows, rice husking machines, and oilpresses), that is purchased at their own expense, women have started saving manual labor.

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ANNEX II-3lPage 5 of 6

Harvesting Rights. The cultivation of rice is a family food crop production. The harvestingbelongs to the family unit, however, men decide upon the utilization of the stored agriculturalproduction. Usually one part is reserved for the meals with guests or the working teams for the otherrice fields, and the other part is used for ceremonies.

Nevertheless, women decide on the distribution of the profits resulting from the cultivation ofvegetables. Part of the production is used for family subsistence, but the majority is commercializedand is an important cash resource for family expenses such as education and medication.

Need for Women in Income Generating Activities. In Guinea-Bissau, the distribution ofrevenues privileges men. Women perform economic activities mainly for the family self-sufficiency,or to pay for family related expenses. They have little decision-making authority in farming. Whilewomen bear the cost of the input factors used in the cultivation of the fields, men control the output.

Development Projects and Improvement of the Economic Situation. Only until recently, hasthe Government implemented projects to incorporate the woman in the economic developmentprocess. Women now benefit from extension services: improved seeds and technologies. Acooperative has been established to overcome marketing difficulties encountered by women specializedin vegetable production. Through this association of women are taught new ways in collectivelyorganizing themselves to commercialize their products. Village-level organizations are encouraged toparticipate in the integrated projects.

Impact of the Vulgarization System on Women. Event though the first projects were orientedtowards the cultivation of cash products, recent projects have focused on alleviating women'sdomestic and productive chores and on increasing their income potential. The 'Integrated RuralDevelopment Projects' are good examples showing how women have managed to organize themselvesand become financially more independent. The introduction of new machineries has contributed tothe improvement of females' productivity and the reduction of physically exhaustion tasks. Throughthe creation of a soap program developed by women, regions which are surplus producers of soap arenow providing to deficit producing regions. Given the lack of educated women, many projects runinto difficulties in recruiting qualified women to promote the success of a project. Therefore, youngwomen are encouraged to enter the Higher Technical School specialized in Agriculture. Tocompensate for the lack of available training in the rural areas, one of the projects includes aneducation component targeting the Northern part of the country. UDEMU is now in the process oftraining rural "animatrices" to promote the integration of women in the economic developmentprocess. This training program comprises courses in Family Planning, Personnel Hygiene, the use ofenergy-efficient stoves, Efficient Housing Construction, and Project Design and Management.

Perspectives. The decision-makers and UDEMU have developed a strategy focusing onimproving the women's situation in the rural and urban areas through ensuring their incorporation inproject development. New projects should:

- assist women in obtaining additional income earning activities to compensate for thelack of revenues generated by the cash crop sales performed by men;

- prepare and implement a survey analyzing women's constraints and needs to improvetheir socio-economic situation;

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ensure that the newly designed projects incorporate techniques aiming to facilitatetheir agricultural and domestic tasks, and develop collective savings systems to satisfytheir credit demands;

encourage the recruitment of rural "animatrices" to sensitize the rural families;

recruit women in associations involved in marketing of agricultural products,negotiating credits for the purchase of production factors to ensure that women'sinterest are represented at all levels of the agricultural activities.

IV. LETTER ADDRESSED TO PRESIDENT OF NIGERIA BY THE MINISTRY OFINTERNATIONAL COOPERATION

This letter expresses the Ministry's commitment, as a governmental representative to thedonor's community, to support all activities focusing on the participation of women in the socio-economic development of the country.

Based on the following facts: women represent the largest proportion of the population,women substantively contribute to the agricultural activities, and women constitute a vulnerable groupthat needs to be included in the development programs, the Ministry of International Cooperation iscommitted to adopt policies that aim to valorize women in the society and to raise equality betweengenders.

Because of the negative impacts of the structural adjustment programs, particularly in theareas of health and education, emphasis has been put on improving women's access to training andeducation in new project selection. NGOs have continued to support projects focusing on protectingwomen as a social individual as well as a labor provider. Among these NGOs, a few specificallyaddress women's issues, others include women component in the overall project design.

At the institutional level, actions have been undertaken to address women concerns throughtJDEMU, the Diocese of Bissau, and public service entities.

All these measures indicate that the Government and national decision-makers are consciousof taking into account the woman's situation in the design of development programs, particularly inthe rural areas.

c:anniii-e.gub (mr)

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GUINEA- BISSAU

PROFILES OF NON-GOVERNMENTAL ORGANIZATIONS

1. Lntroduction: According to the most recent date (1988), there were 69 non-governmentalorganizations (NGO's actively providing subsidies and technical assistance to 111 projects in Guinea-Bissau. Among these, only one project that was in the agricultural production area, included womenas sole beneficiaries. Approximately 42 national and international NGOs provided financial andtechnical assistance to the social sectors (i.e. r in education, 21 in vocational training, and 18 inhealth). Less than half of the NGOs have designed projects that specifically address women's issues.However, in most cases, women's components are part of an integrated package that target a broaderaudience and seek to benefit the community as a whole. In 1988, Guinea-Bissau received US$7.3million in foreign assistance from the 69 NGOs. Less than half of the total (US$3.2 million) wasspent on health, education and training. The social sectors, received approximately 25 % of the totalfunds provided by the NGOs, in the form of technical assistance.

2. Institutional CaDacity Building: The rapid growth of the participation of NGOs in the socio-economic development process (in 1982 there were only 20) in the country has led to theestablishment of Solidari (SOLIdariedade e AMIzade). This organization was created as a publicinstitution under the auspices of the Ministry of International Corporation. Its main objective is tocoordinate the NGO activities in the country, and identify new projects in the different regions andsectors. Assistance is provided in the areas of production, infrastructure, social sectors, researchstudies, and public management. Support to women's activities has been mainly limited to theagricultural and social sectors. The largest number of NGOs are from European origin (54), thenNorthern American (6) and African (5). About 36% of the NGOs in Guinea-Bissau are affiliated withreligious denominations.

3. Within the next year, Solidami is planning an evaluation study to determine the impact ofNGO interventions on the community. The results of this study should assist Solidami in establishinga better regional coordination strategy between the existing NGOs to improve project design, targetdifferent population groups, and to ensure project sustainability. Also, at the national level,collaboration should be improved between the Government and Solidami to increase the supervisingrole of this entity.

4. Social Sectors: In 1988, 46 projects were undertaken in the social sectors of which 22 werein Health, 8 in Education and 16 in Vocational Training. Rural population were the largestbeneficiaries of these projects. A large number of the projects included women components in theirdesigns. A brief profile describing the activities of the principal NGOs involved in women's issuesby social sector, are presented below in alphabetical order.

5. In addition, to the above NGO list, some examples of integrated multi-sectoral projects havebeen attached to illustrate how women have started to organize themselves in various economicactivities.

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- 127 -ANNEX M-4Page 2 of 7

NON-GOVERNMENTAL ORGANIZATIONS INVOLVED IN WOMEN'S ISSUES

EDUCATION AND HEALTH AND OTHER SECTORS

EDUCATION

Africare

Type andDescription: American NGO funded by private donations and US Government

(through USAID) located in Bissau. Support provided by DCHeadquarters.

HumanResources: Two expatriates and one local professional specialized in

education and training, four local support staff. Two localsin the field.

MainActivities: The three-year planned project consist of redesigning the Technical

Vocational Training Program of the National Institute of Technicaland Vocational Training (INAFOR) in the rural areas. Africare isspecialized in providing TA in the area of training trainers andmanagement consulting. Project also includes a program of trainingand seminars abroad. Total project cost is US$2.0 million. Attentionhas been paid to include women in the overseas study program.

FuturePlans: Expansion of short-term training program.

Comment: Africare began its work in 1971 in Sahelian West Africa whenprolonged regional drought claimed hundreds of thousands of lives andparalyzed rural development in many countries. Africare originallyfocused on water resource and agricultural development, public health,and environmental protection.

2. ARO (Swedish African Recruitment Organization)

Type andDescription: Swedish NGO funded by private donations and Swedish Government

located in Bissau.

HumanResources: One expatriate and two teachers specialized in education and training.

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ANNEX III4Page 3 of 7

MainActivtida: In 1988, ARO approved a one-year project complementing and UNDP

education project for Bissau, which began in 1986. The goal of theARO project is to support the National Institute for EducationalDevelopment (INDE), by improving the quality of teaching,rehabilitating school facilities to reduce the dropout rates, stimulatinglearning capabilities of pupils falling behind in the class, andencouraging the participation and integration of each one of them inthe education system. Cost: US$40,104 in 1988.

2. SNV (Dutch Cooperation for Technical and Social Assistance)

Type andDescrlption: Dutch autonomous NGO financed by the Ministry of Cooperation and

Development in Den Haag. Located in Bissau and antennes in thefield.

HumanResoures: In 1989, staff included three expatriate professionals and two

locals. In addition, there are 40 SNV internationals on a three yearterm contract in the field.

MainActivities: SNV indirectly supports activities to women through the financing of

(a) an administrative education project in the rural area, under theauspice of the Administrative Training Center in Bissau. This projectconsist of reorienting the education program to ensure the coursesmeet the labor needs of rural cooperatives, development projects,private and public enterprises (total project cost in 1988:US$181,690); and (b) and education project consisting of improvingteaching materials for health trainers (total project cost is US$46,519for 1988).

FuturePlans: Development of an income generating project for women in Biombo is

in process of being designed.

HEALH

1. Radda Barnen (Save the Children - Swedish)

Type andDescription: NGO funded by private donations and contributions from the Swedish

Government in Bissau. Back-up support provided by Stockholm.

HumanResources: Full-time staff include: four expatriates (physician, resident

representative, 2 nurses) and two locals.

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ANNEX I11-4Page 4 of 7

MainActivities: Radda Barnen activities in Guinea-Bissau began in October 1989 with

the objective to set up a three-year technical assistance program(SKr25 million), starting at the end of 1990. Radda Barnen willassist in strengthening the national Maternal and Child Health Care/Family Planning (MCHCtFP) program. Activities will includeconstruction of new building and renovation of adherent facility;training of nurses and regional assistance to the national ongoingprograms in Sao Tome and Cape Verde. The budget allocation forconstruction is SKr7.7 million.

FuturePlans: Human rights issues targeted to children, and training needs for

families of handicapped children.

Conmnent: Radda Barnen has a successful record of long-time TA in the areas ofMCHC/FP and in pediatric disability and rehabilitation programs.Their planned program would be a significant contribution toimproving the health status of women and children in the RGB.

2. AGBEPSF (Associacao da Guinee-Bissau para Educacao e Promocao da Saude Familiar)

Type andDescription: NGO and RGB affiliate of the International Planned Parenthood

Federation (IPPF) based in London, located in Bissau.

HwnanResources: Staff are all nationals: an Executive Director, two Parteiras, one

health educator, technician, and driver. Part-time staff: one physician.

PrindpalActivities: Founded in Bissau in 1988. Provide clinical family planning and

gynecological medical services. Objectives include (i) improvingliving conditions of population; (ii) promoting child birth spacing;and (iii) training of volunteers to help in the facility. AGBEPSF'sannual budget is US$110,000. Budget increases are five percent peryear.

Comment: AGBEPSF plans to expand its MCHC/PF activities to other regions inRGB.

3. MEGB (Clinica M. Evangelica de Guinea Bisssau)

Type andDescription: A religious and missionary NGO affiliated with a network of

evangelical organizations in the UK. Field representativesin Biombo and Quinhamel.

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ANNEX M4Page 5 of 7

HunmanResources: Full-time staff include four expatriate (UK) nurses, and

national staff comprised of six nurses, two nursingassistants, one technician, three assistants and a driver.

PrindpalActivities: MEGB was founded in 1955. General medical services including

MCHC and FP to a rural population. MEGB offers pre-natal,obstetrical and post-partum follow-up care in its well equippedclinic in Biombo.

Conunent: MEGB plans to disengage its expatriate staff and to turn theentire operation over to its RGB national staff in 1992. For 35years MEGB has been an important source of medical care in theregion. They have had an active program to support birth spacingand have campaigned locally to encourage smaller families andpromote individual preventive individual preventive health.

4. Clinica Catolica e HosDital Maternidade de Cumura

Type andDescription: Non-Governmental Organization, affiliated with and supported by the

Roman Catholic Church.

HumanResources: Full-time staff: consist of four expatriates. Three religious staff:

two nurse-midwives, one health administrator and six nationals.

PrindpalActivities: Regional maternal and child health services - outpatient and inpatient.

Obstetrics, physical examinations, family planning and post-partumfollow-up care. The head nurse provides some nutritional education toexpectant and nursing mothers. Provide contraceptives upon request.

Conmment: The Clinica Catolica gets support from MINSAP and through churchand other organizations in Italy. Most drugs are received directlyfrom Italian pharmaceutical companies

MULTI-SECTORIAL

COE (Conselho Oecumenico das Igregias

Type andDescription: International NGO of religious affiliation.

PrincipalActivities: Implemented the Integrated Project of Caboxanque (P.I.C.), which

started in 1978 and comprises five three-year phases. Project

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objectives consist of improving the living conditions of thepopulation in the southern regions by providing assistance in thefollowing areas: horticulture, pre-natal health care, education, naturalresources (such as potable water), infrastructure and transportation.The project which has a cost of USS120,000 per phase involves 121women.

Future Plans: To expand the number of villages (tabancas) participating in theproject to the more remote areas. Promote the creation of self-sufficient women's organizations.

2. Swissaid

Type andDescription: The headquarters of Swissaid, a Swiss NGO, are located in Berne,

Switzerland. Its field office is in Bissau.

PrincipalActivities: The main objective of the NGO is to provide support to small groups

of population, particularly women, around the Bissau area. Theproject "Gabinete de Apoio Producao Popular (G.A.P.P.)", whichstarted in 1984, assists women in the urban and peri-urban zones inthe production and marketing of soap and palm oil. The project iscurrently in its third three-year phase (1988-90) and its budget wasnot revealed while being interviewed. Two women are the projectmanagers and are facing difficulties in competing with the importmarkets for their products.

FuturePlans: Main objective is to find ways to circumvent the competition problem

by improving their productivity.

3. UNFPA (United Nations Fund for Population Activities)

Type andDescription: International Donor Organization and part of the United Nations.

Location: Bissau, additional assistance provided through Dakar, Senegal(Regional Office) and New York (Headquarters).

PrncipalActivities: One important activity involves the Union Democratica de Mulheres -

UDEMU (Women's Democratic Union) and includes the training of22 rural animators to educate women in areas such as horticulture,family planning, nutrition, husbandry and stove construction(GBS/86/P02 'Regional Integrated Development Project for Women").First phase of project has been completed with a total cost ofUS$365,900. Project needs additional funds to start second phase.

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Comment: UNFPA's Regional Office in Dakar has a staff of capable programofficers who augment the Bissau Office on a regular basis.

4. WFD (Weltfriendene Deutsche Welthungerhilfe

Type andDescription: German NGO. Headquarters are in Bonn.

PrincipalActivities: Weltfriendene Deutsche Welthungerhilfe (WFD) finances and executes

'The Extended Integrated Rural Development Project of BOE'(P.A.D.I.B.). Project started in 1984 and aims to improve people'sconditions in the eastern rural regions of the country. Project includespromotion of horticulture, soap and rice peeling production. It alsocomprises a water pump maintenance, a housing, a ditch and a roadconstruction component. In 1991, WFD contributed DM 298,195and UNDP financed GP 150 million. WFDs contribution has slightlydecreased since 1988, while UNDPs has tripled over the same period.One of the major difficulties encountered are lack of roadinfrastructure and storage facilities leading to gread production losses.

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ANNEX EOR

OUALrrATIA POVERTY PROFLE

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Annex IV-1Page 1 of 32

CURRENT PERCElONS OF POVERTY(translation)

Dr. Aristides GomesALTERNAG, Bissau

A. BACKGROUND

The concept of poverty covers a wide variety of situations. The only factor common to all ofthem is that an individual, group, or country is considered less capable than others of mobilizingresources to meet real or imagined needs for goods and services. Therefore, poverty is a relativeconcept. Even so, in some situations it reduces to zero the ability of human beings to survive, whenthey are unable to protect themselves from the forces of nature or gain access to the things they need toimprove their physical conditions.

How the victims of poverty make sense of their situation depends on their way of life. Thisunderstanding is defined in terms of individual and collective strategies for emerging from poverty.They also vary with overall patterns of social relations. Identifying the different patterns of poverty inGuinean society led us to examine worsening conditions for the production of goods and services inboth rural and urban areas. This decline has resulted from a combination of several variables:

a) decline in rainfall;b) decline in rural labor supply;c) the widening generation gap, which reflects a reworking of social relations including

growing monetization of the peasant economy; and,d) certain measures that are part of the structural adjustment program currently under way.

We interviewed people from the different categories of poor who seemed particularlyrepresentative of the diversity of situations and thus more accurately depicted the national situation.Based on this approach we constructed a comparative sample; we did not make an effort to ensure thateach category was represented in numbers proportionate to its share of the total population.

We considered both subjective and objective perceptions of poverty. Subjectiveperceptions of poverty reveal how feelings about poverty are organized, while objective perceptions arereflected in specific actions taken (in terms of social practice) in response to the overall situation ofpoverty.

B. METHODOLOGY

Sample and Purpose of Study. The sample for this study was designed to understand howdifferent situations of poverty are experienced by its victims by looking at:

1. perceptions of the causes of poverty and the struggle for survival;

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Annex IV-IPage 2 of 32

2. views on how the poor might realistically make their way out of poverty;3. perceptions of how society as a whole is working as gauged through:

a. the relationship of the poor to the educational system;b. their relationship to the health system;c. their relationship with the State; andd. the self-image of the poor.

General Considerations. In general, the perception of some of the persons interviewedregarding their respective living conditions as well as the resources they seek to avail themselves of torealize their ideas of progress are organized around variables such as:

- type of social relations through which the poor relate to other social actors in theirquest for income;

- type of productive activity (goods or services) u well as the means used to obtainincome;

- level of education;- history of the individual in the productive sector in which he or she is operating;- relationship of the poor to the monetized economy;- the individual's position in the social structure.

nhese variables operate u a whole, organizing the perceptions of social groups regardingstrateies for addressing poverty. Nonetheless, the weight of each of these variables in determininghow each group or sector seeks to solve its problems depends on the specific nature of each group.the swift angeover of the poor Mandinga peasant farmer of the East, for example, to charcoalproduction for the market, compared with the attempt on the part of the Balanta peasants of the Southto become part of the money economy, is rooted in several factors. But the main factor is that thesocieties of the Eastern part of the country (Mandingas, Fulas, and Islamized groups) have had a long-standing tradition of operating in a monetized socioeconomic setting.

C. PERCEPTION OF POVERTY AND SOCIAL RELATIONS

The self-image of poor social actors engaged in social relations in which the strength of theireconomic partners is more evident - for example in setting the prices of commodities that are barteredor sold - may reflect an aversion to those partners, who the poor blame for their misery. Peasantswho collect cashews and barter them for rice on terms proposed by the rice merchants have nodifficulty pointing out who is responsible for their life of hardship. As they see it, the merchant makesit impossible for them get more rice in the bargain, since 1 kg of cashew is bartered for I kg of rice.

Poor people who make a living from more self-employed economic activities in which theyhave more equal bargaining power when it comes to deermining the price of their goods, and even theprice of their respective labor power, the 'enemy,' the only you blame for your poverty, is perceivedin a more confused light. In such cases the poor turn to the State to appeal for financial aid orassistance to improve general working conditions.

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Poor people in such occupations speak more often of the need for credit. They include artisans(masons, mechanics, carpenters); pesuats, except cashew gatherers; and small-scale merchantsoperating in the informal sector. These categories of social actors living in poverty operate as thoughthe future of their undertakings depends mainly on their own efforts; so they do not complain about anytype of domination. They also appeal to the State to take initiatives to address their situation. Already-established artisans who run small family shops would like to take out loans to improve workingconditions and thus productivity. Artisans not in such situations, who either alternate or combine wagelabor and short-tem contracts, are seeking stable and lasting employment.

C. COMMERCE AND LAND IN RELATION TO POVERTY

Two images predominate in the self-perception of poor peasants. First is that of poor peasain peripheral areas of the large cities, especially Bissau, who grow rice. Rice is grown on low-lyingriver flats that are deep and retain large volumes of water, which limits the profitability of ricefarming. Living on the outskirts of Bissau, a rapidly growing city, membrs of this group areconcerned that land for growing other cereal grains such is corn, millet, manioc, sweet potato, and yamis becoming ever more scarce. Women, including young women in this group of poor, tend to turn tocommercial activities such as gardening and preparation of cashew wine, while the men turn to cashewgathering. Given the seasonal nature of some of these activities which more and more people areengaged in, especially making cashew wine and harvesting cashews, tension tends to mount in thisgroup. They occasionally migrates to more urbanized areas in search of temporary employment,especially in artisan trades linked to civil construction and domestic employment.

The self-image of the other group of rural poor is significantly marked by the reducedavailability of land for rice cultivation, especially the bolanhas, or rice paddles on river flats. As aresult profitability suffers, or more precisely productivity declines. The situation is more evident in theRegion of Biombo, but is beginning to extend to the salt-water lands in parts of the country with lessrainfall. For the poor in these circumstances, strategies to address poverty and overcome theirdifficulties are bound up with a self-image based primarily on the social and ecological conditionsassociated with rice production. The same strategy can be seen in emigration to Senegal and in thepartial shift by women to cashew gathering and pressing, and the sale of cashew juice and wine.

The poor peasants of the East and North have shifted in part to charcoal production, mainly asa source of money income in an effort to offset losses that have resulted from a decline in rainfall.

While the concerns of poor peasants of the South and North are focused on agriculture andland-related problems, the poor peasants of the East consider land less important for overcoming theircurrent difficulties. Their perceptions as to how they might solve their problems through income-generating work reflect a tradition of commerce on the part of the Islamized populations predominant inthe Eastern zone. The ethnic groups of these regions (Fulas and Mandingas) are represented in largenumbers in the merchant class nationwide. In effect these ethnic groups were involved historically inthe trans-Sahara trade, which prospered and accompanied the spread of Islam to Black Africa.

Virtually all the poor in these regions pose the solution in terms of the need to make moneythrough trade: purchase, resale, and production for sale. Street and market stands (mesas) for the

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resale of goods such as matches, candles, and school supplies have proliferated. These poor arepeasants, stock breeders, and retail commercial operators. Their discourse on how to emerge frompoverty clearly revolves around these three activities.

D. CITY CULTURE, LEVEL OF SCHOOLING, AND POVERTY

City culture and higher levels of schooling combine to make for a different perception ofpoverty. Both variables correlate with substantial integration in the socioeconomic milieu in which thewage labor system plays a major role, and in which social relations are based on the purchase and saleof commodities. Of these commodities, the use of labor is unique.

The use of labor is bought and sold in the informal and formal sectors to produce both goodsand services. Taking into account the State's pre-eminent role in all aspects of socioeconomic life inGuinea-Bissau - it finances the private sector and is the largest-employer - one can understand that theurban poor with more schooling who we interviewed tended to lay blame on the State when asked todiscuss poverty. The educated poor and especially those educated for senior positions who areunemployed or employed but poorly remunerated consistently criticize State management, especiallycorruption.

Most of these better educated personnel who are not able to find a place in the state apparatusof production and management tend to identify with the political opposition, as an organized andsystematized expression of their criticisms of how the State is currently run. This sector of the poorincludes people interested in obtaining positions in the State apparatus, as this would solve theirfinancial problems or offer them an opportunity to apply their ideas regarding, for example, dishonestyin public life.

E. POVERTY BEGETS POVERTY: THE CASE OF SINGLE MOTHERS

Poverty, coupled with low levels of schooling, leads young poor women to engage in lesscautious reproductive activities. Their class culture, deeply rooted in the principles of kinship - indeedthe entire struggle for survival hinges on kinship, even in the cities - considers producing childrenessential for upward social mobility: 'You never know. Perhaps one of them will-be my redeemer."Such statements are typical of poor single young mothers in reference to their efforts to multiply.

Nonetheless, such reproduction among the poor only increases the size of the already numerousfamilies in the "peripheral' neighborhoods and puts young mothers, especially single ones, in an evenmore disadvantageous situation in their daily struggle for bread and betterment in general. Thissituation is considered natural by the poor. One mother commented, 'a woman without children isworthless." It is especially difficult considering that in many cases those children's fathers are youngmen whose social status and age are not conducive to establishing a home.

Girls in this position are at the mercy of men who enjoy better financial circumstances. And soyoung mothers become easy prey to a wide variety of sexual adventures with different partners, for theneed to help support their parents with whom they must live, as well as their children, becomes asource of mounting pressure.

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The practice of having multiple sex partners to try one's luck - for it is said 'you never knowwhich man may be able to save you - reflects a tendency to cling to bope, knowing that a well-offman might always appear who could be the source of financial support for the single mother's(extended) family. This type of disguised prostitution, which is not formally acknowledged by thefamily or community of those engaged in it, is tolerated by the beneficiaries, who pretend not to notice.This strategy for addressing poverty has been used increasingly as poverty has spread.

F. THE POOR AND EDUCATION AND HEALTH INSTITUTIONS

While schooling is viewed by the poor as a means of upward social mobility; how it is handledvaries with the level of schooling. Because their qualifications (which is their capital) resulted from aprocess of schooling, impoverished senior and technical personnel who have been through theeducational system have a more voluntarist outlook. They are better informed about the schools andpay close attention to their children's schooling. When they attack State management of publicproperty their criticisms go directly to problems affecting the schools. Their poverty is alwaysperceived in relation to their consequential financial inability to support their children's education orprovide for their health. In the view of the impoverished senior personnel interviewed, 'the schoolshave declined a great deal," 'our children will not be able to attain the level we have,' 'in contrast tothe well-educated in positions of leadership, we will not be able to send them to the Portuguese schoolin Bissau, not to mention schools in Portugal." 'Medicine is very expensive and we never get a check-up.

The poor with low levels of schooling speak of these issues in terms of luck that may or maynot come knocking at their door. For them their children's success depends on God, on fate, and onthe intelligence of each child; they think that not missing class is enough to make one's way throughschool, so long as you have either God or fate on your side. When discussing their children'sschooling, the poor with low levels of education do not yet criticize the wealthy. This contrasts withthe situation in Latin American countries, as well as some other African countries. Indeed socialinequality in the country is not of a scale so as to draw a sharp line between the lifestyles of rich andpoor.

Today poverty is still marked more by low overall productivity than by economic dominationby one part of society over another. The boundaries of poverty, even for the social sectors with aWestern lifestyle, including the well-educated who are doing well, and certain entrepreneurs, are nothard-and-fast: it is easy to slip into poverty merely by losing your job or suffering mishap in a giventransaction.

G. CONCLUSIONS

The poor feel their own chances for upward social mobility in a given society depend on their realpossibilities of finding or mobilizing the resources they require to meet their needs and theopportunities that society offers lower-class persons to improve their standing in the social structure.

In Guinea-Bissau one can still find considerable opportunities. The national leadership class isin the process of forming. Government scholarships to train senior-level personnel offer major

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opportunities to the urban and rural poor, but with the disappearance of the Socialist bloc, whichfinanced most such scholarships, such opportunities are getting harder to come by.

There are still some reasonable conditions for mobilizing resources to meet the material needs ofthe poor:

* There is a subsistence sector, especially in agriculture, capable of attenuating the drama ofpoverty.

* The existence of a non-structured sector of the economy side-by-side with the familysubsistence sector.

* The strength of kinship which provides social solidarity and redistributes income without Stateintervention.

All these real factors lead the poor to perceive that they have excellent chances of emergingfrom poverty and attaining upward social mobility. There is an exaggerated optimism in the socialconsciousness of the people of Guinea-Bissau. This spirit is reflected in utterances repeated time andagain in the attached interviews, such as: 'As long as I'm alive I can't consider myself poor because Ihave hopes of advancing. For example I could have my own cashew plantation, a retail shop, etc.'

Given below are highlights of several interviews from which these summary observations havebeen drawn.

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Mr. Aliu B.Sex: MaleAge: 50Occupation: farmer, mason

Q. What is your name?A. Alliu B.

Q. In what occupations have you worked?A. I've worked as a farmer, and as a mason's apprentice at the ANCAR company in Bissau.

Q. What is your region of origin? How long have you been in Bissau?A. I'm from Bafata. I've been in Bissau for four years.

Q. Are you unemployed? Since when?A. For the past one month and 20 days.

Q. Do you receive any money from the company where you worked before?A. Nothing.

Q. What was your salary?A. 200,000 pesos.

Q. What is your family's situation? Do you have children? What are your family responsibilities?A. I'm married to two wives, one in Bissau, the other 'inherited' from my deceased older brother,

is in Bafata (where she works in agriculture). I have seven dependents, including six children.

Q. Does your wife who lives in Bissau have other income?A. No. She has no income-generating work.

Q. Why?A. She doesn't have the money to buy goods for resale and she has to take care of our children

who go to school.

Q. How are you getting by at this time?A. Small-scale contracts that I get from time to time. For example, right after being laid off from

ANCAR (because of a shortage in orders) I had two contracts.

Q Contracts for what amount?A. One was for 800,000 pesos, the other 30,000 pesos.

Q. For how many days of work?A. The first for several days, I don't recall exactly, and the second for one day.

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Q Can you tell me of your present difficulties?A. At this time the greatest difficulty I face is the possibiity of illness in the family. If any of my

family members were to fall ill my situation would be dramatic, since I don't have any money.I'm trying to get contracts. I go out every morning to look for work through friends andpeople I used to work with at the company. It's always good to have some regular salary, evenif it doesn't get you through to the end of the month, which was my situation. Mine didn'teven last two weeks, but at least I knew I had something regular I could count on and so Icould anticipate and plan. It's always better because your headaches aren't as bad. At thistime I have many difficulties especially because here in Bissau there are problems gettingagricultural land. The only hope continues to be getting salaried work, which is harder andharder to come by. I beg to God that the ANCAR company may resume its normal activitiesand rehire us masons who were laid off because of the shortage of orders.

Q. Is your other wife, the one in Bafata, supported by you or does she have other ways to get by?A. She is in Bafata. I had to "inherit her' and father more children with her because my brother,

her former husband, passed away. Fortunay she works the land that my brother her formerhusband left her. She is there along with the children left by my brother, as well as otherchildren who she's had by me since my brother's death. My duty is stay with her there fromtime to time. I just came back visiting her three days ago. She is raising crops and living withher children. From time to time I bring her food. When I don't have anything to bring Iborrow, mainly from neighbors and friends. I feel ashamed standing before my children whenI have nothing to help feed the family. I not well when I'm unemployed. It's terrible.

Q. What do you think the future has in store for your children?A. Every day I beg God that my children will go on to become doctors or engineers. Only God

can help them as he helped me acquire my profession as a mason. I never thought that wouldbe an option for me when I lived and worked the land in the region where I'm from.

Q. Do you belong to any group of masons that has organized to seek work collectively throughorders?

A. No, not yet. Some other masons have subcontracted me. I have sought out contracts but forshort-duration work, for I hope they'll call me back to work with ANCAR some day. And I'dprefer that, since it's always better to have a regular salary.

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Mr. Bailo S.Age: 50Occupation: Peasant, producer of charcoal for saleRegion: BafatiMarried to three womenDependents: nine children, four nephews and nieces, one auntSchooling: lliterate

Q. Could you describe your sources of income?A. I am a farmer. I grow rice, for which I burn trees, as wel u corn, ndo, sweet potatoes, and

manioc. In the dry season I work hard to produce charcoal, which I sel. Nowadays farmingalone isn't enough to meet all our needs. We need money. Charcoal brings in money that wecan use to buy other goods, especially clothes, sometimes even rice. Farming alone has itsrisks: when it doesn't rain much you're in a tough spot.

Q. Could you discuss the difficulties you face in your work?A. My difficulties began with the scarce rainfall when I was working as a peasant. Producing

charcoal my difficulties have to do with not having a draft animal. I don't have any money tobuy a donkey and less charcoal is sold in the area where I produce it. I have neighbors whoare able to sell more than me because they have carts drawn by donkeys and can quickly bringtheir output here to the city of Gabd, or take it to the main road where more customers passby.

Q. Do you see any way to improve your working conditions, especially as regards your means oftransport in the near future?

A. No. I don't see any solution without money. And I don't have any opportunities to get moneyto solve the problems I mentioned.

Q. What do you think of the health system here in your village?A. I think it's not bad. We have vaccines for the children, treatment for fever and care for

pregnant women.

Q. And your children's education?A. I inow that they go to school. I want them to go on but I don't know what grade they're in

now.

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Mr. Fernando B.Sex: MaleAge: 65Profession: carpenter (retired)

Q. What are your current sources of income?A. I'm a carpenter retired from the Ministry ofAgriculture. I worked my whole life on the

Pessube Farm. Now I receive a retirement pension of 87,000 pesos each month. Fortunatelymy wife works growing vegetables near here. Right now she's the family's main breadwinner.If she didn't do this work, I don't know how my family would eat. I also make simplefurniture, such as chairs, stools that I sell. But this doesn't bring in much. I also makewooden trunks.

Q. And is the house you live in your own, or do you pay rent? How many dependents do youhave?

A. In all I have 13 people: my wife, my children, and two wives of a brother of mine, who alsohave children. Fortunately we don't pay rent because the house we live in belongs to myyoungest brother, now deceased, who was an Armed Forces officer. This was unfortunate forme, because he was a brother whom I could count on for renovating this house. He wouldhave been able to help a great deal to get a government loan, among other things. But Goddetermined otherwise. As a result I've been asking other people outside the family for favors.For example, I had to ask a friend to lend me one million pesos just recently to replace thethatched roof of this house. As you must know, all thatched roof houses need this each year.

Q. How do you intend to improve the family situation in the future?A. We could stand to benefit from State assistance. Assistance in the form of a loan could change

the situation, and I think that even if I die, my children would be able to pay it off before toolong. For example if I had zinc sheets I wouldn't have to depend on thatch, and I need torenovate the house.

Q. What do you think of your children's schooling?A. Everything is in God's hands. I would like them to go on. And I need money. But I don't

see any way to get the money I need so that those who are still studying don't have to drop out.Some drop out because I can't even pay the enrollment fee. The oldest is looking for work,but hasn't found any. Medicine is expensive, it's no longer given out at the hospitals.

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Mr. Saido I.Married

Q. Do you have children?A. Yes, I have children.

Q. In which region were you born?A. I was born in the region of Gabd, in Pirada.

Q When did you come to Bissau?A. I came in 1976.

Q What type of work did you do in Pirada?A. I lived at my parents' house and farmed with them.

Q And in Bissau?A. In Bissau I started at the auto body shop where my brother worked. The owner of the shop

was a guy by the name of Pedro. My brother was already trained and worked at the shop, butfor himself, using some of the owner's supplies, or through subcontracts. I was an apprenticeat that time. I worked as such for six years, so my brother Pedro was supporting me.

Q. You didn't earn anything?A. I wasn't paid anything as an apprentice.

Q. After those years of apprenticeship did your brother continue to support you?A. After that I went to another shop, Pipi's, where I worked for one year. There I practically

worked for myself, since my training enabled me to fill certain orders. It's just thatconsidering that I did my own work on the site in his shop, I paid him, since he had otherexpenditures to meet, for example he paid the security guard.

Q. Did you work with the owner's supplies or with your own?A. The supplies were mine. I bought them with the money I earned.

Q. When did you come here?A. I came here right after leaving Pipi's shop. About 10 years ago.

0. Who is the owner here? What is your work arrangement? Do you pay rent?A. There's an owner. All the chiefs here pay rent. I pay as head of the auto body shop, but

there is also a chief mechanic (their boss) who also pays rent. We work alongside oneanother, because we can't make a profit in our businesses if we don't share a space. Each ofus pays 200,000 pesos monthly. And each works for himself.

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Q. You mentioned bosses a moment ago. Can you get into the details?A. Yes, I can. In effect I have some apprentices, just as I was an apprentice, under my technical

supervision. And the mechanic as well.

Q. How many do you have?A. I have seven.

Q. What is your arrangement with them? On what basis do they work?A. They've come to learn. They're not able to fill the orders because they've yet to be qualified

to do so. They're here under my orders, and help me do the work while they learn. I'm theone who takes in the money paid on the invoices, but as compensation I feed them. My wivesbring lunch here every day and we eat together. Of course when there are jobs that don'trequire much in the way of technical qualifications, for example fixing a door that isn't closingproperly, certain customers trust our apprentices, and then they are paid directly. Otherwise Itake the job, I make an estimate, I do the job with them, and I'm paid directly.

Q. You've spoken of several wives. How many do you have?A. I have four.

Q. How many dependents do you have at home?A. I have my four wives, nine children, one brother, and two of my uncles' children.

Q. Do you live near here?A. No. I live in the Military District.

Q. Do you rent your house or is it yours?A. It's mine.

Q. How did you manage to build your house? Can you elaborate on that?A. Yes I can. I built it with the income from the shop and with the help of a brother who works

in Portugal.

0. What type of work does your brother do in Portugal?A. He works in construction.

Q. Does he have training in that field?A. When he went to Lisbon he knew nothing about it. He went to look for work, and that's what

he got.

Q. Do you rent out part of your house?A. No. I use all the space. It has eight rooms, and a zinc roof .

Q. Do your wives do any income-generating work?A. Yes, they sell juice, peanuts, and other things.

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Q. They sell juice? So you have electricity at home?A. No, but they take the juice to the home of a friend who has a refrigerator and electricity in his

house. I used to live in that house.

Q. What do you think the future holds in store for your profession?A. I think it's a profession of the future. There's always work so long as people keep driving.

Q. What difficulties do you face at this time?A. At this time I have some difficulties. There's not enough fuel, vehicles aren't circulating. So

there's not much repair work to do. When that happens we practically don't have any work.

Q. Do you have a rough idea of your income?A. My income ranges from about 800,000 pesos, at times like this when there are fuel shortages,

to 1,500,000 pesos a month.

Q. Do you think you could say that you are a man who has gotten ahead in life?A. I think so. I came to the city to get work and I was able to lift myself out of poverty.

Q. Do your children go to school?A. Yes, five girls and four boys. The boys don't go any more. The girls go to the Islamic school

as well as the public school.

Q. What professions would you like to see your children take up?A. I think that how my children's education advances will depend on how my work goes. If they

do not go very far, each wil turn to a profession as he or she sees fit. I may be able to teachthe boys the work involved in my profession.

Q. You said that how far your children will go in school depends on the future of your work. Doyou have an idea how much upper-level education costs?

A. I don't know anything about that.

Q. Has anyone in your family been very ill recently?A. No. I was sick during the fasting period, but it wasn't serious, just malaria.

Q. Do you think medicine is expensive?A. Some, but not those used for malaria.

Q. Changing subjects, I'd like to ask you again about your occupational future. Do you think it'seasy to set up a business in your field? if not, what do you think it takes?

A. It's not easy to obtain a locale. Not only do you have to know how to do the work, you alsohave to make yourself known. You have to get a place through an owner; and the Stateshouldn't impose such heavy tax burdens on us. For example, the State is beginning to requirethat we pay a tax (fortunately we've yet to pay it).

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Q. Can you talk about how you use your income?A. Usually I 'm able to put away some when things are normal. That is, when the circulation

of vehicles isn't hampered by fuel shortages. Laty I've had problems saving because thecompetition is getting stronger and I have a growing number of dependents in my family.

Q. Did you build your house before or after marrying your four wives?A. It was after I had married all of them.

Q. Were you able to save for other things in addition to building your home?A. Yes. For example I bought a car (Peugeot 404) four years ago, which I used as a taxi and then

sold. I also had expenses when I married my wives, even though they were not all that much.

Q. How do your wives use their income?A. They use their income as they see fit. They don't give me anything. I buy them clothes from

time to time, for after all I am the man.

Q. Is it possible that you'll still get a loan for your work?A. Yes, it's possible and I'd like that.

Q. Besides the loan, do you see other ways of achieving your goals?A. I intend to save money for that project, even though I realize that it's difficult. I plan to join

up with a mechanic, as our businesses are complementary. Apart from that I don't see anyother solution. I also wanted to enclose the space where I work, but the State wouldn't allowit, arguing that it would create aesthetic problems.

Q. Besides your obligations here in Bissau to the relatives we already discussed, do you have anyother family obligations?

A. Yes. With the elderly of our family in the countryside. From time to time I send rice or sugarto those relatives.

Q. Is there a room for another professional near here? Wouldn't it be more difficult for yourbusiness to turn a profit with competition so nearby?;

A. He would not be welcome. We would pressure the owner of this space, but if it were tohappen the owner would take the opportunity to increase the rent we now pay.

Q. Have you ever sought a bank loan to upgrade your business?A. Yes, to set up a shop. But unfortunately it didn't come through.

Q. Where did you want to set up shop?A. I intended to set up a shop in a locale and officially register my business.

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Q. How did you pull together the money for your first investment? Do you belong to some agrupo de abota (system whereby each member of the group pays a quota and then has the rightto draw on the savings on a revolving basis)?

A. I saved money from my work. At that stage of the apprenticeship process I was alreadyworking on orders. I never belonged to a grupo de abota.

Name: CamalaAge: 24Place of origin: Bula, Region of CacheuEthnic group: Mixed Mancanha and BalantaSchooling: Eighth grade. Is studying, but not this year due to lack of money.Civil status: Single.

Q. Where did you live and how did you make a living in Bola?A. In Bola after my father died I lived in the house of an uncle of mine who works the land. I

helped out in farming work, which is the whole family's livelihood.

Q. When did you come to Bissau? Where are you living now? How are you making a living?A. I came to Bissau in 1988 to continue my studies. I lived and to this day continue to live in my

cousin's home. He has fed me and covered all my educational expenses.

Q. What is your cousin's occupation? Does his family have other sources of income in addition toyour cousin's?

A. My cousin is the head of a family and a driver. In addition to his salary he has a plot of landin Mansaba and another in Bula, which we all farm in the rainy season.

0. What does your cousin drive?A. A State service vehicle.

Q. How many dependents does he have?A. He has four wives; in all there are 23 of us who depend on him.

Q. Could you say more about the family's sources of income? Are there any other sources inaddition to your cousin's job and the money that farming brings in?

A. My cousin's wives work in the 'green belt' (vegetable-gardening). Most of the younger familymembers go to school and farm with us during the rainy season.

Q. Who has covered your educational expenses?A. My cousin paid for enrollment and I've always found a way to pull together the rest.

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Q. How?A. For example, I help my uncle, who still lives in Bola, and I also work occasionally, especially

during vacations, for other peasants in Bula, for pay. Right now I'm working here as anemployee in a small-scale vending operation.

Q. When did you begin to work as an employee in small-scale vending operations?A. I began this job January 22 of this year (1993).

Q. Who is your employer?A. A Mancanha man who I met in one of the poor neighborhoods near where I live.

Q. How much does he pay you monthly?A. As we agreed, 200,000 pesos per month.

Q. What merchandise do you sell?A. As you can see I sell matches, juice, chewing gum, almonds, ballpoint pens, pencils,

notebooks, tobacco, etc.

Q. Does your employer have other sales stands?A. Yes, he has other stands in the Belem neighborhood (here in Bissau).

Q. Do you think you can be considered a poor person at this time?A. No. No way. So long as I'm alive, I have hope. So long as I'm alive and in good health I

don't think I'm poor.

Q. Does this mean you have hopes that one day... ?A. Yes. Indeed I think I'll be able to get rich.

Q. How?A. I think my current job or another one will enable me to get rich

Q. In any event, you say you face some difficulties. That's why you had to interrupt yoursecondary studies to take this job. How do you intend to emerge from your currentdifficulties?

A. I plan to be able to set up my own sales stand. Beyond that, I have a small cashew plantationwhere I keep planting more cashew trees. Right now I have about 140. I had to plant on theland my deceased father left me on the outskirts of Bula. The cashew trees began to bear fruitlast year.

Q. Have you obtained legal tide to the land where you planted cashew trees?A. Not yet.

Q. Is ownership of the land in dispute?A. No. There are three of us siblings, two boys and a girl. She is married, and my brother and I

plant a few cashew trees, each on his own plot.

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Q. Turning to another matter, have you had serious health problems of late? If not, have any ofyour relatives had such problems?

A. I had some problems, but not very serious. I had malaria. My cousin bought the medicine,which I know is very expensive at this time. There isn't any at the hospital, which is not howthings used to be. Now we have to buy it. I think I'll be able to get by if my current job lastsa long time.

Q. Do you think you're well paid?A. I think so, taking into account that I was unemployed. Being dependent on my family gave me

several headaches. Now I think I can do something. Now I have opportunities to dosomething, I'll even be able to save, and I intend not to squander.

Q. Has your relationship with your cousin changed since you got your current job?A. Before I felt very shy towards my cousin. I was ashamed because I often had to ask him for

money; sometimes I even lost my appetite. I think it was a good idea to interrupt mysecondary school studies. Even if I have to go back I will opt for job training.

Q. With the financial independence you now enjoy, are you thinking of living on your own?A. I'm thinking of that, but first my current job would have to become more secure.

Q. You spoke of your desire for job training. What type of career appeals to you?A. I want to finish ninth grade and then look for an accounting program, for example.

Q. Are they any other courses of study you might like to pursue?A. I'd like to learn to work as a plumber.

Q. Do you have information on the professional courses of study offered in the country at thistime?

A. Just these two.

Q. Why would you choose these?A. Because I think I could really enjoy them.

Q. You said a moment ago that your plantation is not yet profitable. When it brings in moremoney, how do you intend to use it, together with what you get in your salary?

A. I intend to contribute financially to the expenses of the family where I live-buy things such asmatches, tobacco, juices, school supplies, and eventually set up my own sales stand.

Q. What advice would you give young people your age who are in the same social circumstancesas you?

A. We are different in terms of how we think and act. Certain young people in my situation onlythink about dressing well and going dancing. I think I'd tell them to adopt a modest lifestyle,not to live like people in better financial circumstances. They should help their relatives whohave helped them in the past, for example helping with farm work, and when they have asalary paying a share of the family's expenses. Young people from the cities in general do not

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return their relatives' favors. In addition, they don't accept agricultural work, even when theirsituation is tough.

Mr. Muzsa E.Age: 26Schooling: Seventh gradeUnemployed and has never had a job(seeking employment)

Q. Where do you live and how do you make a living?A. I'm looking for work.. I think my Inowledge would be useful for intellectual work. I think

work that requires physical exertion is not for people like me, considering my inowledge.Construction work is tough. I'm looking for a technical job.

Q. You mention technical work. Do you think you have technical qualifications?A. No, but I could acquire those skills in school, for example, at the CENFA, at the Chico Te

School (a teacher-training institute). If I graduated from one of those schools, I could findwork and would then be able to help my family. I'm now living at home with my parents.They support me. My father is a mason and my mother grows vegetables. They need my helpto continue providing for my brothers and sisters and other family members. There are a lot ofus, 17 in all.

Q. Can you tell me of an experience you've had in the course of looking for a job?A. I've tried at the customs service and at the Stenaks company. At the customs service I waited

for an answer that never came. At the second company you had to take a test that was nevergiven. Perhaps they've taken on other people who they wanted to hire and decided not to givethe test.

Q. How do you view your prospects for getting work?A. The situation is very difficult for young people in circumstances such as my own. I would like

to be able to continue my studies, but I don't have the means to do so and there are noscholarships. Now it's hard to get a scholarship. As I said before, I'm still trying to get a job,but it's impossible. Only heavy work is available. Another solution that people of mygeneration have is to emigrate to Portugal. But now it's impossible to get a visa. I hope theState will do something.

Q. You mention that you might like to emigrate if possible.A. Yes.

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Q. Where to?A. Portugal, France, etc.

Q. Would you accept any type of work in those countries?A. Anything.

Q. Even heavy-duty work that involves considerable physical exertion?A. Tbere's no other solution. Those jobs also pay more. Some of my friends have already sent

their parents cars to be used as taxis.

Q. Do you consider yourself poor?A. Not all that poor. I think there'll be a solution. I'm young and I think things are going to get

better.

Ms Amelia S.Age: 48Schooling: IlliterateOccupation: Market gardeningCivil status: MarriedHusband's occupation: PeasantPlace of residence: Pessaaque

Q How many dependents do you have, and how does your family get by?A. At home my husband and I have 18 people in our charge. We live off the land. I cultivate the

land, preparing seed-beds for the production of vegetables, and my husband grows rice. Hereceives help from nephews and sons who live with us, and I receive help from our daughtersand nieces.

Q. Is the house yours or do you rent?A. Fortunately it's ours. We built it a long time ago, before most of our children were born. But

it's made of thatch, so we have to replace the roof each year. And that costs a lot of money.It needs to be replaced each year before the rainy season.. Right now the thatch for a housecosts approximately 1,200,000 pesos. We want to get zinc for the house. The problem ofhaving to replace the roof periodically would be solved for good.

Q. What difficulties do you face in your work? For example, is the area you cultivate your own?A. That's where the difficulties begin. The land I cultivate is not mine, it's my brother's. But

people say that a road is going to be built through the land. For now it's fine, we're notpaying the owners anything. We just give up these plots to the respective owners during therainy season; they grow rice, since there's a lot of water. Other difficulties we've had have to

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do with the pests that eat and contaminate the vegetables. When there is a plague we areforced to buy products or pay specialists to spray the crops. People also uy that housing willbe built on the land we cultivate beyond the road I mentioned. This is a source of greatconcern, for if all of these projects are carried out, we (and there are many of us cultivatingthese plots) would be in serious financial straits. It's not easy to find lands such as those wecultivate. Growing vegetables for market requires good land; we need low4ying lands withabundant water.

Q. So you're concerned about your work situation loocing to the future?A. Yes,Iam.

Q. And if everything turns out as you expect, what do you intend to do to get past the difficulties?A. That's what you want to know? Perhaps you would provide assistance in such a case, you who

work with the State?

Q. I'm not from the State. I work with PASI, as I said at the outset.A. If I don't find an alternative or new lands, I would stay home and care for my children. It

would be tragic, but you've got to be patient.

Q. And if the State were to give assistance, what type of assistance would you prefer?A. For example, for buying tomatoes in the interior to sell them here in Bissau.

Q. What do you think of your children's schooling?A. It's very difficult. We don't have the money for many things they ask for. It would be good

for them to try to acquire a profession and later get a good job.

Q. Do you know what grade they're in?A. I can call them over and they'll come here and tell you. I only know that some don't go any

more because they want money for this and that, and I don't have it.

Q. What do you think of the country's hospitals and medical care?A. Medicines are very expensive, but at least they're available for sale. It's better than before.

Q. Do you have anything to add?A. No.

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Mr. Jost C.Age: 42Occupation: Peasant and workerMarried to two wives

Q. How many dependents do you have, and how does your family get by?A. I have six dependents. We live off the land, but I work as a carpenter. I mintly grow rice,

because where I live I no longer have land for farming corn, fivSdo, beam, maniac, or otherproducts. I also have a small cashew plantation and so I participate in the cashew harvest; Ibarter cashews for rice sold by merchants. Working in the cashew harvest has compensted forour inability to raise the other crops I just mentioned, due to lack of land; they had accountedfor a significant share of the crops we used to produce. In the family we produce cashew wineand juice.

Q. Where is your plantation, and when were the cashew trees planted? What problems are youexperiencing right now?

A. The plantation is in Donde. The cashew trees were planted by my father, who has since died,when I was still a child. Also, my wife sells tomatoes, which she buys in the East and sells inand around Bissau.We've had major difficulties. The rice lands we cultivate are very low-lying, so when therainy season comes water builds up, making it difficult to work the land. When that happenswe have to wait a month for the water to circulate before we can go back to work.As for the cashew trees, a lot of rain is synonymous with low productivity, which means littlefruit and not much in the way of cashews.In the current situation we need money to be able to farm. In order to get labor, even fromfriends and colleagues who can help us, you have to have enough rice, meat, and alcoholicbeverage to offer them a meal after each working day. , My strategy is to do wage labor duringthe off-season, when I'm not engaged in agricultural work. The money I earn is enough to buythe staples I need to offer food and drink to my friends who will help me cultivate my plot.We till it at the time of the first rains in June and plant in July. in September we plant again,My own output is not enough to feed my family. Sometimes I have to give manioc to thosewho help me work the land. It's only because of the cashew harvest and work that Ioccasionally do that I'm able to survive.

Q. What is the arrangement whereby your friends help you? Do they help just in exchange forfood and alcoholic beverages?

A. We join forces and work for all the members of the group on a rotating basis. But when thegroup is working your farm, you should give them food and drink to help them gear up for thework.

Q. Is the rice you get in exchange for your cashews enough to feed your family?A. In Donde, for example, one kilo of cashew is traded for one kilo of rice. It's impossible to get

enough rice on those terms, which compounds our difficulties.

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Q. What do you think of your children's schooling? Is it expensive?A. It's not expensive because enrollment costs only 3,000 pesos. Well now it's 5,000 pesos. But

the problem is that when our children grow up we'll need them to work. It all depends onGod. They will be what God wants them to be. For my part, I encourage them, I don't letthem miss class. They can and they should help us in the future.

Q. What do you think of the hospital system where you live? Are you satisfied? Do you trust it?A. Medicine is expensive. Nowadays to get anything done you need money, and money is hard to

come by. The hospital system isn't bad, the only thing is you've got to have money.

Mr. Paulo T.Age: 46Married to two wives, has six children.Occupation: rice farmer, cashew gatherer, and masonRegion of origin: BiomboPlace of residence: Prgbis

Q. Could you describe the work you do to support your family?A. We make a living by growing rice, gathering cashews, and my work as a mason. I have a plot

of land on which I grow rice, we all participate in the cashew harvest, and I work from time totime as a mason, under contract. I do this as part of a group. We work in Bissau during theoff-season. My wives work in commerce, mainly buying and reselling tomatoes.

Q. Could you describe the difficulties you currently face in your different areas of work, and themain problems you face in your daily life?

A. Salt water reaches part of my plot. I've had to take up gathering cashews, while my wiveshave taken to making cashew wine. When the cashew season begins we all get involved; evensome of my nieces, who usually perform domestic work in Bissau for a salary, come back.One serious problem here is that the merchants give us a kilo of rice for a kilo of cashew. Weneed rice not only to feed ourselves but also to feed those who help us with farming work fromtime to time. Fortunately the girls in our family go to Bissau to work as maids and the boys topick chabeu (oil palm kernels) and produce palm wine, which they sell. I also get some moneyincome when I work as a mason. This year I was able to buy zinc to replace the roof on myhouse. I think I'll be able to breathe easy because I'm free of the hassle of having to buy newthatch each year to replace the roof on my house.

Q. How do intend to overcome your current difficulties?A. I think our children have to be able to help us in the future. The State has to help us get zinc

for the roof.

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Q. And your children's schooling?A. I think that, God willing, they'll do well so they'll be able to get good jobs. I do all in power

to make sure they don't miss class. I hope God will point the way to success for them. If thatdesire is not realized, patience. Without an education life is difficult because you can't get agood job. Take the case of a nephew of mine who is under my charge: I gave him all the helphe needed to get his driver's license. I paid what had to be paid, he took a log time to learn,now he's got the driver's license, but he's not yet been able to get work in Biau as a driver.Perhaps he could get a decent job if he continued his studies. I need money for mychildren's education. Otherwise, they'll have to interrupt their studies at some point to helpme With the work to earn income to support the family.

Q. What do you think of the hospitals in Guinea-Bissau?A. I think it's hard to rely on them 100%. For example here in Prabis there's not much medicine.

Tlere's more in Cumura at the health post run by the priests.

Mr. Tidfilo N.Age: 48Occupation: Hauls goods by cart.Married to three wivesHas five childrenDependents: 17 relativesRegion of origin: Biombo, lived in Quinhamel.

Q. What are your sources of income?A. I face great difficulties. The plots I used to work after I was laid off at the Naval Shipyards in

1987 dried up and were infiltrated by salt water. I'd worked at the Naval Shipyards since thecolonial epoch. In 1986 they announced that the company was having problems and so theywere going to cut personnel. In 1987 I was laid off and had to go back to where I'm from totry to farm again. It was a short-lived. The family plot left by my father was in poor shape..It was damaged by the drought and by salt water from the ocean. In addition I found a familythat was having a hard time getting enough people to help work the land. All those factorsmade production hardly profitable. I have to go back to the city to seek a regular moneyincome. At this time I've got one foot here in Bissau and the other in Quinhamel. There Iraise crops and pull the cart at the Bandim market.

0. Could you explain in more detail the process of your work 'pulling the cart"?A. It involves transporting goods that people buy at the market and taking them to these people's

homes. It's a way of competing with the vehicles that do the same work. Yet we don't reallycompete with them, since they are cut out to cover long distances and to transport large

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quantities of merchandise. Those of us who work pulling carts carry small quantities becausewe are small, for example, four bags of cement or a few boxes.

Q. Do you think it's a job with a good future?A. For the time being I can make a living from it, I can buy rice that I take to the people who help

me farm my plots during the rainy season in Quinhamel. I don't Inow what's to come, but forthe time being I can say that I've found a way to make a living.

Q. Does your family have other sources of income? Your wives for example?A. My wives are all in Quinhamel. They are working in the production of cashew wine at this

time. After makling cashew wine, they'll help grow the rice. From time to time, when it isneither rice-growing season nor wine-mak-ing season, they bring mangos and other fruits here toBissau to sell. They and my children always have something to keep them busy. When theycomplete one type of production or activity they begin the next. And that's how we get by.

Name: Maessa-BiaiAge: 27Occupation: domestic workerSingle, no childrenPlace of origin: Varela (Cacheu Region)Temporarily residing in BissauParents' occupation: Farmers

Q. What are your sources of income?A. At this time I have only one source of income, working as a domestic employee. I'm now

earning 200, 000 pesos. I've been doing this work for three years now.

Q. What did you do before?A. Before I worked in my parents"house in the region where I'm from. I was involved, like all

girls my age, in the work of growing rice, corn, manioc, and other crops. But since myparents, like all other farmers, began to feel an increasingly pressing need for money, I had tocome to Bissau to look for a job, to help my family.

Q. Do you have other plans for the future?A. I don't think that working as a domestic will solve my problems in the future. Things are

getting more expensive all the time. Some of my acquaintances, even relatives, do the samework I do, but at this time of year they press cashews to produce wine. I plan to save somemoney and then start selling tomatoes. I'll go to Varela, buy tomatoes, and bring them toBissau and other places to sell. It pays well. I need to plan for something of the sort, for soonI may have children and so my expenses will increase.

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Q. Could you describe your education, which yon mentioned a moment ago?A. I wasn't in school for long. I completed second grade of elementary school. In the

circumstances in which I grew up it was not possible or at least it was very difficult to get pastthat level. There was a lot of work to be done and my family placed more priority on work, tothe detriment of school. And here in Bissau I began to understand the importance of school.When I got here I didn't even know how to read. Now I can read some things. I understandthe importance of school because even if you're going to work as a domestic some familieswant you to be able to read and write some.

Q. Do you think the State could do anything to help people with plans similar to your own?A. I think so, but I don't think it would give us the money we need to invest in the business.

Q. What do you think of the hospitals?A. I think that medicines are very expensive now. In the neighborhoods the health centers

distribute certain medicines free of charge, especially malaria medicine. It appears theyprovide good service to pregnant women. My oldest sister has a good impression of thesecenters. She just had a baby, and had several check-ups during her pregnancy.

Q. How do you use your salary?A. Since I live in my brother's house -- he's a civil servant I help pay for the family's food. I'm

only there weekends because I sleep and take my meals at my employers' home. So I have asalary of 200,000 pesos plus room and board. I have to save money to invest later on; I haveto hold traditional religious ceremonies from time to time; I have to prepare for my father'sburial, for he is old. You need cloths, and hiring weavers is very expensive. I have manyexpenses. All this makes it difficult for me to go into business.

Mr. Pepesseco N.Married, one wife. Has five children and three nephews and nieces and one cousin living in the house.Age: 50Ethnicity: PepelOccupations: rice farner; also worked as night-shift security guard.Place of residence: Outskirts of Bissau)

Q. What are your sources of income?A. I have a plot I cultivate that yields a bit of rice. It doesn't yield much because at times there's

a lot of water, which reduces output. There was a time when I worked as a night guard. I didthat for many years, but I had to quit recently because the salary was not very good. My wifewas dealing in tomatoes and other vegetables, but had to stop because of her health. She wasvery sick. She had become very swollen. We went to the hospital to see the doctor; he gaveus a prescription and to buy the medicine we had to spend all the money we had saved. She'sbetter but can no longer do tiring work. I had a cashew plantation but people came from the

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city, soldiers cleared a large part of the plantation, occupied the land, and built their houseswithout paying me any compensation. Since they're members of the military I went to Amura(General Headquarters of the Armed Forces), and I went to the City Council of Bissau tocomplain, but nothing has been done to date. One of the expropriators promised to help one ofmy children get a visa to emigrate to Portugal, perhaps to calm me down. But nothing hashappened so far.

Q. What do you think the future holds in store for you? Can you foresee any solution to yourproblems?

A. I think the State should provide a great deal of assistance to solve the problem of plots where alot of water collects, because they are very deep and the State should ensure employment for usand our grown children. Before I thought my children should emigrate, but now it's so hard toget a visa and it seems that in Portugal even with a visa you run the risk of not being able toenter through the airport. This is all getting much more difficult.

Q. What do you think of your children's schooling?A. I hope they can go on, God willing. Those who are in school go every day. If God enables

them to think as they must, they'll go far. I pay the enrollment fee each year because I thinkthat the more they advance the better off I'll be. I also have a son who plays soccer. I hopehe'll be able to make a living from it. It appears that in Portugal they earn more money withthat. I'd like for him to be able to go to Portugal and try his luck. I have hopes in mychildren's education, but if they don't want to continue their studies, out of lack of initiative orpatience, they'll look for work. Of course it'd be good for them to be able to obtain a stableand well-paid job.

Q. What do you think of the hospitals?A. I think medicine is extremely expensive. I'm speaking based on experience. My wife was ill

not long ago and it was very hard for her to regain her health. Fortunately, we had a little bitof money saved up and we also had to sell all our animals in order to buy the medicines weneeded. Another concern arises when people get very sick here in the rural areas of theoutskirts of Bissau. It's very hard to get them to the hospital. We go to the primary healthcare center for small headaches and fevers. But when there are crises things get complicated.You have to get out to catch a taxi and that's hard where we live.

Mr. Juliao S.Particular situation: BlindAge: 50

Q. What is your region of origin?A. I'm from Cai6, region of Cacheu, where I worked as a peasant farmer.

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Q. How long have you lived in Bissau?A. I've lived in Bissau since 1962. I was at the Santa Isabel Home and in treatment for one year

in Lisbon.

Q. Do you work in Bissau? How are you making a living?A. Yes. I was a shoemaker for 15 years. I have a disability pension that comes to five thousand

pesos monthly. I have a small thatched-roof house near the airport, and my wife works as ahairdresser. From time to time we raise animals here in the shack where we live.

0. Do you have any plans for overcoming your current difficulties, for example as regardshousing?

A. I do, it's just that I can't because I have practically nothing. As you can see, we live in ashack and the rainy season is upon us. The roof doesn't protect against leaks. I got some zincsheets by selling part of my land by the airport.

Q. Do you think your wife's small-scale commercial activity could solve some problems?A. That requires money. Money brings in more money. Someone, or the State, has to help us.

We were given shelter by a neighbor after the house collapsed; and the priest at Antula gives useight kilos of rice each month.

Q. What do you think the future holds in store for your two children?A. The older one was an apprentice in a mechanic's shop. I would like him to leam an occupation

in the area of refrigeration. And if he had time he could continue his studies. I think that inthe future they'll go as far as their intelligence and God will take them. We expect a great dealof our children because the situation is getting more and more difficult. The older one muststart working.

Q. You mentioned that the situation is getting worse. Can you say more about that?A. It's enough to see the prices of medicine, for example. Everything is very expensive. My wife

can no longer buy the peanuts that she used to buy to resell.

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Maria A.Age: 26Civil status: Single Mother of 2 daughtersOccupation: NonePlace of residence: Bissau, Bairro de AJudaSchooling: 6th grade

Q. What are your sources of income?A. I don't work. It's very hard to find a Job. I live with my mother, my two daughters, and my

youngest sister, who's going to school. I have a friend who helps me out financially. Mymother works in small-scale retail commerce. I do too. It's just that I've had a very hard timegetting some money together to invest. Two months ago I received financial assistance fromsome friends; I had to go to Gambia, where I bought textiles and that I then sold here inBissau. And with that I bought three months of rice for the family. I'd like to do this workregularly, but I don't have the money I'd need to invest.

Q. Do your daughters' fathers help out?A. Not regularly. My first daughter's father is in France. He emigrated because things here were

not going well for him. He didn't have steady employment. My second daughter's father nowhas more responsibilities. I thought he'd be the mainstay of my family. But he's very soughtafter by women. He is better off because he works in commerce. The aid he gives ourdaughter is also irregular, but it's better than what we get from my first daughter's father.

Q. What do you think the future holds in store for you?A. The situation is difficult for me and my family. I have energy to work, it's just that I don't

have money to invest. I hope to get a man of means, one who could help me in this regard.Yet I know it's hard to get a serious man in this day and age. No one marries any more. Sowe have to take advantage of the fact that we're alive to support our children, who arepractically fatherless.

Q. A moment ago you mentioned your friends who help you. Could you say more about yourrelationships?

A. You want to know quite a lot (laughs). They're friends who I go out dancing with from timeto time. They're willing to help out. And so we have to deal with the situation, and you know thatmen in today's world only help you out based on their interest in whatever. Since I don't have ahusband, I can't just stand around waiting.

Q. And what do you mean by "just stand around waiting"?A. It means I have needs to meet. Financial needs, and my friends have helped all this time that

I've not found a husband, which has made it possible for me to bear the burden of supportingmy daughters, my mother, and my sister.

Q. Are your daughters already in school?A. No. They're not old enough.

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Q. Have you begun to think about your children's education?A. Not yet, though I think it'd be a good idea for my daughters to have advanced degrees. That

would be nice if it were possible.

Q. What do you think of the schools in Guinea-Bissau?A. I think they're not what they used to be. Nowadays, it seems that students know less, and

however much they study there are no jobs and no scholarships for studying abroad.

Q. And what do you think of the health system?A. I think some things are good, for example, primary health care in the neighborhoods, especially

because they work with pregnant women and children. But in the hospitals the situation is verydifficult. There are many sick people and few beds, few nurses. There are also a lot ofobnoxious nurses whose comportment is not becoming of their profession. Working conditionsin the hospitals are not good. There was a time when there were even power outages in thehospitals. There aren't enough beds, etc. Medicine is increasingly expensive. Things aregetting more and more difficult.

Mr. Abdulai D.Age: 39Married, three childrenEngineerRegion of origin: Bissau

Q. Could you briefly tell me of your social background up to the time you received your degree asan engineer?

A. I studied at the Kwame N'Krumah school in Bissau. I taught there before going to Romaniafor my university studies. In Romania I concluded my training in electronics. When I taughtat the secondary school before going to Romania, my standard of living was much better than itis today. It's incredible but true. Today I'm an engineer; I work in the company that marketsgas, and my earnings are not just enough to support my family for one week. I'm living in aroom in this neighborhood, which you've seen -- myself, my wife, and our two children.

Q. What do you think are the causes of this situation?A. I think it's poor management of the country's wealth. There's a great deal of squandering.

Some people are living beyond the means afforded by the country's resources. It can't go onlike this. Why doesn't the State make loans to the well-educated to enable them to build theirhomes? How can I be productive in the conditions in which I live? Here in the house I can'twrite, I can't study, I can't even keep my books. I think that the situation has got to beremedied and that limits should be placed on the number of fancy cars that some (just a few)privileged people bring into the country. My salary is ridiculous. I'm now earning 30,000

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pesos, which is equivalent to US$ 50. This whole situation persists because the stealing neverends. Corruption has reached alarming proportions. Budgets are being slashed across theboard while money is sent to foreign bank accounts.

Q. Given what you just said, what do you think the future holds for you? To begin with, whatyou intend to do to cover your current needs?

A. At this time I can say that I live in poverty. My wife works in one of the offices of theMinistry of Education and earns less than 200,000 pesos. We live off ofher salary and mine,nothing else. We can't even go out to eat. At one time I thought about emigrating evenwithout having any job secured in the country where I would have gone -- since I have my wifeand children here. I've been looking for contracts in construction. I can install electricalsystems. But it would be better to set up a business in that field. Since the Bank has no moneyfor loans because those people wasted everything, I have to get some contracts and save somemoney to start up a business.

Q. When did you return from Romania? How did you end up in the company where you'reworking? is your position right for you?

A. I came back in 1989. I'm not in the right position here. I'm not doing electrotechnical work.I'm here to keep from being unemployed. You have to keep up your morale. That's why atwork we senior-level personnel say that the State pretends to pay us, and we pretend to work.I 'm here to be in charge of natural gas distribution. I feel I'm gradually losing my skills. Ifthis continues a few more years I don't think I'll be an electrotechnician any more.

Q. And the solution?A. The solution? The State has to rethink all this. Well-educated personnel need to have

incentives to create small enterprises, which yield the best results. If I were receivingassistance I would already have a business for installing electrical systems, for example in civilconstruction.

Q. What do you think the future holds in store for your children?A. You know as well as I that the country's school system has deteriorated significantly. I can't

afford the Portuguese school or the French school. It's a disaster when I see the notebooks ofmy nieces and nephews who are already in secondary school. My children are still veryyoung, but I'm worried about their future. And their health as well. A short time ago I hadterrible problems when my youngest was born. His mother always has difficulties inchildbirth. She was hospitalized for two months before delivery. I had to buy everything,from the syringesfor injections to medicine and food. It was a rough period. I had to take outloans regularly at work, which I'm just now beginning to repay, and from friends.

Q. Do you have dependents?A. How do you mean? Soon my cousin, a nephew, and two of my wife's brothers will be living

in my house. Fortunately all these people will be coming next month when I'm going to moveinto the house next door, which has two bedrooms and a living room. You know when youreturn to the country with training for a senior post the whole family thinks you're coming backto save them. And so they start sending everyone to your house arguing that we were able to

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get an education thanks to the family's support, and that therefore we should provide support toothers in turn. In addition I help my father and mother meet their needs. And I need moneyfor ritual ceremonies.

Mr. Caetano A.Region: GabuAge: 25Schooling: 4th year of secondary studies

Q. You're no longer in school?A. I'm no longer in school.

Q. Why?A. Because at my eldest brother's home, where I was living, I only received food. I had to cover

all my other expenses, including school supplies.

Q. Where do you live now?A. I'm renting a room in M'Pantcha where I'm paying 20,000 pesos.

Q. What are your current sources of income?A. At first I intended to do everything needed to acquire a profession. I even worked as a

mason's helper; I worked for a time but wasn't paid. I was staying at my eldest brother'shouse and the home of my employer in construction. I had to give up the work as a mason'shelper and get into the sale of building materials: crushed rock, stone, sand. I began this workin 1992. I buy these materials from people who collect or stock them, rent a truck, and takethem to construction sites to sell.

Q. What kind of earnings do you make?A. There's no fixed rate of earnings. The price of the materials varies depending on negotiations

with the seller. The price is subject to negotiation, but in general I eam 10,000 to 30,000pesos for each truckload of materials sold.

Q. What difficulties do you face in your work, and what are your prospects for the future?A. The difficulties have to do with the fact that sometimes the people who buy materials from me

don't pay. It's a temporary job. I intend to enroll in the Technical School to learn masonry. Ithink the solution is to have a profession because there's no security in the work I'm doingnow. The main purpose is to save something to be able to emigrate. If that's not possible --even though I think it's the ideal solution -- I'd enroll in the Technical School. I thinkemigrating would be ideal because my impression is that here in Guinea-Bissau things will onlyget more difficult.

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Q. Do you have some countries in mind? Do you know what life is really like for emigrants inthose countries?

A. I've thought of France and Portugal, for example. I think it's somewhat difficult, especially inPortugal, but because some immigrants there don't take as serious an approach to things as theyshould. As for me, if I leave the country, I'll work hard abroad, and I think I'll be able toreach my goals. I think that by attending the technical school in Bissau in training as a masonI'll be able to get work in Portugal or France.

Q. What do you think of schooling here in the country?A. I think that education is becoming less and less valuable here. The differences between the

students of the past and those now in the system are more marked with each passing day.Education is deteriorating.

Q. What do you think of the degrees offered here in the country?A. Many people get degrees nowadays by paying the directors of schools.

Q. Do you think studying in the country is worthwhile?A. I think so, because many people with important positions but without the appropriate level of

education have to be replaced. They have to be replaced. But for this to happen we need morehighly-educated people. But with my level it's harder and harder to get a good job.

Q. What do you think of the health care system?A. The situation is bad. Very bad. When a sick person comes to the hospital here in Gabui it's

sometimes hard to find anyone to attend to him. But it appears that things are worse in Bissau.And then there's the cost of medicine, which is extremely high.

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Republic of Guinea-Bissau Poverty Assessment and Social ...

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