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SCS Guinea: Citizens’ Involvement in Health Governance Period of Performance: July 28, 2017 – October 26, 2020 Funding provided by: United States Agency for International Development Cooperative Agreement No. AID-675-LA-17-00001 Final Performance Report Submitted: January 25, 2021 Submitted to: Mark Koenig, Agreement Officer’s Representative (AOR), [email protected] Souro Kamano, Alternate AOR, [email protected] Albert P. Asante, Agreement Officer, [email protected] Bernadette Daluz, Senior Acquisitions and Assistance Specialist, [email protected] This report was prepared with funds provided by the U.S. Agency for International Development under Cooperative Agreement AID-675-LA-17-00001. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the U.S. Agency for International Development. TABLE OF CONTENTS Table of Contents ............................................................................................................................. i Acronym List .................................................................................................................................. ii Executive Sumary ........................................................................................................................... 1 Project Overview ............................................................................................................................ 4 Technical Approach ........................................................................................................................ 5 Overall Strategy .......................................................................................................................... 5 Summary of CIHG Activities ..................................................................................................... 6 Project Results .............................................................................................................................. 45 Lessons Learned and Recommendations ...................................................................................... 52 Annexes......................................................................................................................................... 59 Annex I: Performance Indicator Table ..................................................................................... 59 Annex 2: Summary of CIHG Achievements ............................................................................ 63 Annex 3: CIHG Communications Poster .................................................................................. 64 Annex 4: List of CIHG CSO Partners ...................................................................................... 65 Annex 5: List of CIHG Media Partners .................................................................................... 66 Annex 6: List of CIHG Listening Groups ................................................................................ 67 Annex 7: CIHG Success Stories ............................................................................................... 68 Annex 8: Summary of Good Governance Barometer Key Phases .......................................... 72 SCS Guinea: Citizens’ Involvement in Health Governance Final Performance Report: July 2017 – October 2020 Page i ACRONYM LIST AFJ Association des Femmes Journalistes de Guinée (Association of Women Journalists in Guinea) AGIL Alliance Promoting Governance and Local Initiatives AGUIFPEG Association Guinéenne pour l’Implication des Femmes dans le Processus Electorale et la Bonne Gouvernance or Guinean Association for the Involvement of Women in the Electoral Process and Good Governance AIDE-Guinée Initiatives, Actions, and Development for Guinea ANSS Agence Nationale de Sécurité Sanitaire (National Health Security Agency) AP Action Plan CBO Community-Based Organization CCAP Citizen Control of Public Action CEGUIFORD Centre Guinéen pour la Formation, la Recherche et le Développement (Guinean Center for Training, Research, and Development) CENAFOD Centre Africain de Formation pour le Développement (African Training Center for Development) CIHG Citizens’ Involvement in Health Governance CJMAD Comité Jeunes Mon Avenir D’abord (Youth Committee My Future First) CNERS Comité national d’éthique pour la recherche en santé or (National Ethics Committee for Health Research) CNOSCG Conseil National des Organisations de la Société Civile Guinéenne (National Council of Guinean Civil Society Organizations) COSAH Comité de Santé et d'Hygiène (Health and Hygiene Committee) COVID-19 Novel Coronavirus 2019 CSO Civil Society Organization DMR Directions de Microréalisations or Directorates of Micro-Projects DO Development Objective DPS Direction Préfectorale de Santé (Prefectural Health Directorate) DRG Democracy, Human Rights and Governance DRS Direction Régionale de Santé (Regional Health Directorate) EPI Expanded Program on Immunization FEDIPHU Femmes pour le Développement Intégré et la Promotion Humaine (Women for Integrated Human Development) FY Fiscal Year GGB Good Governance Barometer (Baromètre de la Bonne Gouvernance) GoG Government of Guinea IR Intermediate Result KII Key Informant Interviews LGL Le Groupe Lyceum (The Lyceum Group) LOP Life of Project MATD Ministry of Territorial Administration and Decentralization MEL Monitoring, Evaluation, and Learning MOH Ministry of Health MP Member of Parliament SCS Guinea: Citizens’ Involvement in Health Governance Final Performance Report: July 2017 – October 2020 Page ii MSS Mutuelle de Santé et Services (Mutual of Health and Services) NA National Assembly NA-HC National Assembly Health Commission OH Outcome Harvesting PNACC Programme National d’Appui aux Communes de Convergence (National Program of Support to Convergence Communes) PNC Prenatal Consultation POP Period of Performance RAJGUI Réseau Afrique Jeunesse de Guinée (African Youth Network of Guinea) RFA Request for Applications SCS Global Strengthening Civil Society Globally SFCG Search for Common Ground SI Social Impact THP Traditional Health Practitioner TMG Technical Monitoring Group URTELGUI Union des Radiodiffusions et Télévisions Libres de Guinée USAID United States Agency for International Development SCS Guinea: Citizens’ Involvement in Health Governance Final Performance Report: July 2017 – October 2020 Page iii EXECUTIVE SUMARY To support Guinea’s post-Ebola recovery and strengthen health governance, USAID determined that more effective and more extensive collaboration among Guinean civil society, media outlets and the government was critical to further improve health service delivery and enhance public confidence in the public health system. Therefore, USAID designed and launched the three-year Citizens’ Involvement in Health Governance (CIHG) project to improve citizens’ understanding and participation in Guinea’s health-system reforms, by expanding opportunities for civic- governmental dialogue, increasing access to information about health governance, and improving advocacy. Led by FHI 360, in partnership with Search for Common Ground (SFCG) and Social Impact (SI), CIHG collaborated with Guinea partners from civil society, government, public and private healthcare professional at the national and local levels. CIHG is part of USAID’s on-going Strengthening Civil Society Globally (SCS Global) leader with associate award (LWA), with 18 associate award projects across the world. The project supported numerous complementary activities: capacity building and multi- stakeholder collaboration opportunities for government officials, media outlets (namely radio), and civil society organizations (CSOs) through workshops, coaching, field visits, community theater, listening groups, and planning seminars. CIHG provided technical and financial assistance to produce extensive health-governance reporting, especially via radio. The grants program facilitated Guinean-led research to identify remaining reform priorities, implementation of coalition-mobilization activities, use of social accountability tools and advocacy. CIHG significantly contributed to improving citizens’ understanding of and participation in Guinea’s health-system reforms as evidenced by monitoring, evaluation, and learning (MEL) data and the findings of the endline study. More than 175,000 Guineans engaged in initiatives to improve health governance. In total, 55,298 people participated in multi-stakeholder forums bringing together government officials, civil society representatives and the media to identify needed improvements in health governance and health service delivery. At least an additional 120,000 Guineans participated in mobilization activities designed specifically to engage community members both to increase citizen understanding of health reforms and to strengthen civil society participation in health governance. The total number of people mobilized is a conservative figure, using only verifiable data. The findings from the endline study reaffirmed this increase in citizen engagement. In all, 22% of respondents reported direct involvement in activities to improve local health facilities, and 67% indicated knowing other community members engaged in these efforts. A majority of respondents reported that women and youth are participating in health governance activities: 68.7% reported that women are well or fairly well engaged, while 65% said that youth are well represented in health governance. Almost half of the outcomes identified through the endline outcome harvesting
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