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Paraguay
>> Regional Overview >> Paraguay Overview Activity Data Sheet
PROGRAM: Paraguay
TITLE AND NUMBER: Use of Voluntary Reproductive Health Services Increased, 526-006
PLANNED FY 2001 OBLIGATION AND ACCOUNT: $2,495,000 DA
PROPOSED FY 2002 OBLIGATION AND ACCOUNT: $2,025,000 DA
STATUS: New
INITIAL OBLIGATION: FY 2001 ESTIMATED COMPLETION DATE: FY 2005Summary: Reproductive health care is important in Paraguay because of a desire to solve two acute problems in the area of human reproduction: 1) the unacceptable levels of maternal mortality and infant mortality (69% of which is attributable to preventable disease) and 2) excessively high levels of fertility. Effective health care delivery at the community level can be strengthened by channeling services through local democratic institutions. A significant foundation for improved decentralized health services design and delivery at the municipal level has already been created with USAID support. This decentralization of the provision of health services complements efforts to strengthen democratic processes, while effectively addressing health concerns.
Key Results: Two intermediate results will be achieved under this objective: (1) decentralized community based health care will be provided; and (2) access to quality reproductive health services will be expanded.
Performance and Prospects: USAID will build on its past program, maintaining a focus on increasing the use of reproductive health services. USAID will also improve decentralized community health care, increase community participation, encourage local-level management of health providers, and build NGO capacity. Technical assistance is being directed at providing health services through local governments and the private sector. Community outreach programs will be strengthened, including the development of a reproductive health promotion campaign, and donor coordination will continue to be enhanced. This objective is closely linked with the democracy strategic objective, and activities will be mutually reinforcing.
With the implementation of health decentralization now progressing at all levels and the continued downward transfer of both authority and responsibility, USAID believes that a framework exists for improved delivery of basic reproductive health services. Other multilateral donors, NGOs, and private sector providers will be engaged in extending coordinated reproductive services to appropriate components of the Paraguayan population. The division of labor (both geographical and categorical) should enable widespread coverage of the populated areas of Paraguay.
The Ministry of Health (MOH) recently finalized a new National Reproductive Health Plan for the country. USAID will, in coordination with national-level authorities, including the Technical Planning Secretary, the National Women's Secretary, the MOH and others, support the effective implementation of this and other national-level policies throughout the country. Local health councils will be an integral part of community participation activities related to health planning. USAID will build on current successes in increasing community participation in the health sector, as well as in other areas. Strengthening community participation, through local health councils and other means, will result in the delivery of appropriate services that meet local demands. Strengthened participation in health service delivery will contribute to more transparent public management in general and the creation of an empowered civil society.
USAID will implement a demonstration model of a maternal health system. The model uses design teams whose members include local MOH officials, hospital and clinic health administrators, health providers, traditional birth attendants, and community members. These teams identify the most significant barriers to the provision of quality maternal health services and devise local solutions to their problems. Interventions are directly aimed at increasing the demand for services through information, education, and communication activities and assuring essential obstetric care is provided to women during pregnancy and childbirth.
During FY 2001 and FY 2002, funds will be used to improve decentralized community based health care ($1,145,000 in FY 2001/$805,000 in FY 2002) and expand access to quality reproductive health services ($1,350,000 in FY 2001/$1,220,000 in FY 2002).
Possible Adjustments to Plans: No changes are expected.
Other Donor Programs: Initiated by USAID, a donor roundtable on health was recently established to coordinate successful experiences and to plan for the future. The client oriented, provider efficient (COPE) model to improve the quality of health care initiated by USAID is being expanded to other areas of the country by the World Bank, the United Nations Children's Fund (UNICEF), and the United Nations Fund for Population Activities (UNFPA). The UNFPA is also expanding the contraceptive logistic management system designed for the MOH with USAID assistance. UNICEF intends to strongly support future decentralization efforts and is committed to coordination with USAID.
The World Bank has a project to decrease maternal and infant mortality in six departments in rural areas of Paraguay. The Inter-American Development Bank is implementing a similar project to provide a parallel range of services in five additional rural departments. The Pan-American Health Organization (PAHO) is working in health sector reform; the institutional development of the MOH; epidemiological surveillance of infectious diseases; and health promotion and prevention in maternal, child, and mental health. USAID has cooperated with PAHO in activities related to health sector reform and decentralization.
The German Technical Cooperation Agency has a program on reproductive health for adolescents. The Japanese International Cooperation Agency is starting a project that will strengthen maternal and infant health services in three rural departments with a strong emphasis on training nurses and obstetricians. USAID is actively participating in an interagency task force on maternal mortality that includes other donors, the MOH, and other GOP agencies.
Principal Contractors, Grantees, or Agencies: USAID implements the program through the following U.S.-based organizations: Population Services International, Engenderhealth, Johns Hopkins University, and the Centers for Disease Control. Local organizations funded by USAID are the Paraguayan Center for Population Studies; and the Information and Resources Center for Development and Promotion for Health Improvement.
Paraguay: 526-006
Performance Measures:
Indicator FY97
(Actual)FY98
(Actual)FY99
(Actual)FY00
(Actual)FY00
(Plan)FY01
(Plan)FY02
(Plan)Indicator 1: Targeted facilities that have the capacity to provide basic essential obstetric care. NA NA NA 0 NA 20 40 Indicator 2: Number of target facilities providing adequate health care. NA 0 NA NA NA 10 13 Indicator 3: Communities offering basic health services. NA NA NA 0 NA 3 5 Indicator 4: Couple years of contraceptive protection (CYP) NA NA NA 167,000 NA 180,000 200,000 Indicator Information:
Indicator Level (S)or(IR) Unit of Measure Source Indicator Description Indicator 1: IR Percentage Program Evaluations. Percentage of targeted facilities that have the capacity to provide basic essential obstetric care. Indicator 2: IR Number Ministry of Health (MOH) and program reports. Number of target facilities providing adequate health care in these elements of quality: technical competence, choice of contraceptive methods, and information given to clients. Indicator 3: IR Number Program evaluations. Number of communities offering basic health services which includes, local health plans, a data collection process, a basic health packages definition, a system of promoters and financial and management information systems funcioning. Indicator 4: SO Number The Ministry of Health, local NGOs and the Pharmacies Association's annual reports of contraceptive supply distribution The number of couples protected from pregnancy by family planning services during a one-year period, based on the volume of all contraceptives sold or distributed during that period. U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 0 DA 0 DA 0 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Fiscal Year 2000 0 DA 0 DA 0 CSD 0 CSD 0 ESF 0 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 0 DA 0 DA 0 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Prior Year Unobligated Funds 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 2,495 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 2,495 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 2,025 DA 12,500 DA 17,020 DA 0 CSD 0 CSD 0 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA
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Last Updated on: May 29, 2002 |
