July 2017

Country Profile on Nutrition Guinea-Bissau

The European Commission (EC) is continuing to work multisectoral strategic nutrition plan was finalised (budget strategically to secure traction on its commitments to reduce not yet validated). However, the country’s political instability stunting and to allocate EUR 3.5 billion (2014-20) for this hinders implementation of the sectoral strategies defined by purpose1. Preliminary results for 2016 indicate a three-fold the Government. In 2013, the Civil Society Network for Food increase in the EC’s commitments to nutrition since 2014. and Nutrition Security and Sovereignty of Guinea-Bissau This is a significant development, but this pace of investment (RESSAN) was formally created. However, only during 2016, needs to be maintained in order to reach the pledge by with the support of the EU, this network has become more 2020. The scope to achieve this lies in the strategic design of proactive in developing approaches to influence government’s programmes that are still to be funded – especially in the focal policies and raise public awareness. RESSAN is also member sectors of Food & Nutrition Security, Sustainable Agriculture, of the Food and Nutrition Security Council of the Community Health and Education – so that nutrition is integrated alongside of Portuguese Language Countries. other objectives. This approach is particularly relevant to the new EU Consensus on Development which places emphasis Number of stunted children under 5 on human development and dignity as well as partnership, Current prosperity, peace and the planet itself.

Child stunting in Guinea-Bissau has been decreasing, 2014 0.076 million from 36.1% in 2000 to 27.6% in 2014. Despite significant National target improvements in exclusive breastfeeding rates, complementary feeding practices continue to be inadequate (only 8% of

children aged 6-23 months have a minimum acceptable diet). 2025 Poor hygiene, low access to improved water and sanitation 0.046 million and basic health services as well as teenage pregnancies WHA Target (amongst nearly 1 in 3 girls aged 15-19 years) are also key determinants of undernutrition. A national survey in September 2016 showed high rates of food insecurity (30.6%) and acute 2025 0.046 million malnutrition amongst children under 5 (10.3%), probably due Expected according to current trend to the seasonality, floods consequences on cereal production and the erosion of livelihoods due to the difficult economic

context of the country. Since joining the SUN movement, 2025 Guinea-Bissau has committed to improving nutrition for 0.073 million all, as well as reducing child and maternal mortality rates and strengthening socio-economic indicators. In 2016, a

Progress against the World Health Assembly targets2 Data last referenced by EU

GNR 2016 analysis of progress WHA (and SDG) nutrition indicators Prevalence Number Year Off course - Some progress Stunting of children U5 years of age (SDG2) 27.6% 75 640 20143 Off course Wasting of children U5 years of age (SDG2) 6.0% 16 443 20143 On course - Good progress Overweight of children U5 years of age 2.3% 6 303 20143 Currently off course Anaemia of women of reproductive age 44.6% 343 435 20114 NA Low birth weight 11.0% – 20104 On course Exclusive breastfeeding of infants U6 months 52.5% – 20144

International Cooperation and Development Profile on Nutrition in Guinea-Bissau July 2017

Trend, projection and targets in the prevalence and number of children (under-five) stunted

80

70

60

50 0.078 0.069 0.076 40 0.073

30 1.753% The rate of stunting 1.747% 20

Prevalence of stunting (%) reduction has accelerated 0.082 0.046 between 2012 and 2016 Government and WHA 10 target by 2025

0 1985 1990 1995 2000 2005 2010 2015 2020 2025

Number of stunted children estimated by surveys (million) Average annual rate of reduction in stunting estimated in 2016 Projected number of stunted children calculated in 2016 (million) Average annual rate of reduction in stunting estimated in 2012

Implications for development planners

Guinea-Bissau has experienced a marked decline in the prevalence of stunting since 2000. But, the decline in the number of children stunted has been only marginal due to population growth. Recent projections anticipate that Guinea-Bissau will not meet the World Health Assembly (WHA) target by 2025. The rate of decline in the number of children stunted has accelerated somewhat, from 1.747% in 2012 to 1.753% in 2016; if this is maintained, then about 73,000 children are expected to be stunted in 2025. This is well over the WHA target, and by extension, that of the principal indicator for Sustainable Development Goal 2 (SDG2). Consequently, additional efforts are required by the government and development partners to change Guinea-Bissau’s course and secure the level of stunting reduction needed.

Nutrition governance

Yes/No Comment Member of SUN Movement Yes Since 2014 Government’s commitment Yes The Government of Guinea-Bissau has committed to reduce the rate of stunting by 40% by to nutrition (including N4G 2025 (as per the National Nutrition Policy, and in line with the WHA target). event) Multi-sectoral policy Yes The revised National Nutrition Policy (adopted in 2014) provides a multi-sectoral framework framework nutrition for nutrition actions. A Multi-Sectoral Strategic Nutrition Plan 2016-2020 was finalised and budgeted in 2016 (budget not validated yet). A common results framework remains to be developed. Multi-sectoral platform for No A multisectoral platform has not yet been formalised but a technical working group supports nutrition coordination nutrition-related activities, under the aegis of the Ministry of Health. A National food and nutrition security council may be established to oversee the formulation of a national food and nutrition security strategy. Profile on Nutrition in Guinea-Bissau July 2017

EU financial commitments to nutrition 2008–2016

Data collected March 2017

The EU commitments to nutrition in Guinea Bissau through Preliminary results for 2016 indicate a 3-fold increase in DEVCO from 2008 to 2016 are illustrated below in Figure 1. the EU’s global funding commitments to nutrition since Under the 11th EDF National Indicative Programme (NIP) 2014 as illustrated in Figure 2. The total amount of funding 2014-2020 for Guinea Bissau nutrition is prioritised through commitments for nutrition globally in the last three years is the Food and Nutrition Security and Sustainable Agriculture EUR 1.8 billion, which represents 51 % of the EU overall (FNSSA) focal sector to which EUR 34 million have been financial commitment for the period 2014-2020. In 2016 allocated. By the end of 2016, no funding was committed alone, the EU’s financial commitments to nutrition have yet and a total of EUR 17.5 million is identified for upcoming reached EUR 790 million. This is a significant development, programmes. EUR 3 million5 is committed in 2014 for nutrition but this pace of investment needs to be maintained in order to from 11th EDF B-envelope as per the SUN methodology). reach the EUR 3.5 billion target by 2020.

Progress against the EU’s financial pledge to reduce stunting 2014-2020:

Commitment of Allocation of €1.8 €3.5 BILLION BILLION

over the last 3 years 2014–2016 total global pledge 2014–2020 51%

Figure 1 Figure 2

DEVCO Nutrition commitments in Guinea-Bissau DEVCO and ECHO global commitments 2014–2016 to (In EUR million) 2008-2016 the EU pledge of EUR 3.5 billion to nutrition 2014–2020

12 4000 EU pledge of EUR 3.5 billion 10 2014–2020 3500 EU pledge for Nutrition 8 commitments between 3000 2014–2020 6 DEVCO and ECHO 4 2500 Nutrition commitments 2014–2016 2 Nutrition in EUR million

DEVCO commitments for commitments for DEVCO 2000 DEVCO Nutrition

0 EUR million DEVCO and ECHO Commitments 1500 contributions 2008 2009 2010 2011 2012 2013 2014 2015 2016 2014–2016 Commitment year 1000 DEVCO contribution

500

0 Profile on Nutrition in Guinea-Bissau July 2017

Support of the EU and Member States

NIP Focal sector(s) for nutrition 2014–2020 • Sustainable rural development • Health sector also includes some nutrition (sector leading on nutrition) specific interventions.

Enhance mobilisation and political commitment for nutrition

Potential support to the SUN movement at country level In particular, consideration of the accountability framework of will be considered, once the political situation allows. the SUN movement in Guinea Bissau would be very useful.

Scaling-up actions

The scale-up of nutrition-sensitive interventions directly Health projects “Programme Intégré pour la Santé supporting populations have been financed under the areas Maternelle et Infantile” (UE-SAUDE, PIMI-I and II) are of rural development and health through the Transition Funds, improving the quality of nutrition services for children, both as follows: at community level and in health centres (for surveillance and management of undernutrition). Projects aimed at improving access to safe water and improved sanitation. Future scaling-up of nutrition-sensitive interventions under the 11th EDF aim to strengthen resilience and socioeconomic Actions in nutrition and agriculture (reallocation of 10th opportunities through agriculture value chains activities. The EDF) including direct assistance to the most vulnerable programme will seek to maximise agriculture contribution to populations, promotion of sustainable changes in the nutrition, recognizing the multiple benefits from having access, access and availability of food to strengthen resilience of availability and use of a variety of foods and the importance the population. of the agricultural sector for supporting rural livelihoods.

Rural development project aimed at the sustainable improvement of socioeconomic conditions in the regions of Bafatá, Quinara and Tombali. This project has complementarities with the above projects in agriculture, nutrition and health as well as those funded under the thematic line.

Strengthen expertise and knowledge-base

Strengthening of monitoring information systems under Supporting the Cost of Hunger Study in Guinea Bissau in the above actions in nutrition and agriculture (reallocation order to improve knowledge and advocacy (11th EDF). of 10th EDF and under 11th EDF).

1 The EU stunting reduction target is embodied in the EU’s Communication on Enhancing Maternal and Child Nutrition and the Action Plan on Nutrition to operationalise that policy 2 http://www.who.int/nutrition/topics/nutrition_globaltargets2025/en/ 3 Inquérito aos Indicadores Múltiplos (MICS) 2014, Principais Resultados. Bissau, Guiné-Bissau: Ministério da Economia e Finanças, Direcção Geral do Plano, Instituto Nacional de Estatística (INE) 4 Global Nutrition Report (GNR) 5 CRIS number: 24-967 – EU contribution amount: EUR 4 million – nutrition score: partial – nutrition amount: EUR 1 million. CRIS number: 24-997 – EU contribution amount: EUR 8 million – nutrition score: partial – nutrition amount: EUR 2 million.