MILLENNIUM GOALS IN GUYANA · Guyana country office for providing financial and technical support,...

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“ Without the Millennium Development Compact, poor countries will remain trapped in poverty,with low or negative economic growth.

Public Investments in poor people spur economic growth, while economic growth sustains such investments.

National Strategies for the Millennium Development Goals must include a commitment to women’s rights, to education,reproductive health services, property ownership, secure tenure and labour participation”

United Nations Millennium Development Compact - 2003

The Millennium Development Goals Progress Report:An Agenda for Action, An Agenda for Partnership.

JAN SAND SORENSENUN Resident Coordinator, Guyana

JAN SAND SORENSEN BERNADETTE THEODORE-GANDI SREELAKSHMI GURURAJAResident Representative, UNDP Country Representative, PAHO/WHO Assistant Representative, UNICEF

HELEN-MARIE GOSSELIN DANIEL BLANCHARD FLAVIO MIRELLARegional Director – Caribbean Office Director – Sub-Regional Office Officer-in-Charge, UNDCPUNESCO ECLAC

HETTY SARJEANT SANDRA EDWARDS DAVID BOWENRegional Representative – Caribbean Office Regional Programme Director - Regional Representative, FAOUNFPA Caribbean, UNIFEM

GRACE STRACHAN PHILIP CROSSDirector- Caribbean Office, ILO Representative, ITU

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Acknowledgements

This report owes its existence to the contributions made by several individuals and organisations.

The Ministry of Foreign Affairs is particularly grateful for the close collaboration of the UNDP –Guyana country office for providing financial and technical support, and especially the advocacy and

leadership of the former Resident Coordinator/Resident Representative Mr Richard Olver.

Contributors to this report include the Bureau of Statistics, Dr R Cummings of the Ministry ofHealth, Ms Evelyn Hamilton of the Ministry of Education, Mr Winston Jordan of the Ministry of Finance,

Mr Rudy Collins of the Ministry of Foreign Affairs andMs Denise de Souza of UNDP.

Pictures were generously provided by a number of sources, including and Ms Karen de Souza ofRed Thread.

LIST OF ACRONYMSAIDS Acquired Immune Deficiency SyndromeEPA Environmental Protection ActFDI Foreign Direct InvestmentGDP Gross Domestic ProductHFLE Health and Family Life EducationHIPC Highly Indebted Poor CountriesHIV Human Immune Deficiency VirusICT Information and Communications TechnologyIDA International Development AgencyIFI International Finance InstitutionIMCI Integrated Management of Childhood IllnessesIMF International Monetary FundIMR Infant Mortality RateMDG Millennium Development GoalMMR Maternal Mortality RateNPV Net Present ValuePHC Primary Health CarePRS Poverty Reduction StrategyPRSP Poverty Reduction Strategy PaperSIMAP Social Impact Amelioration ProgrammeSTD Sexually Transmitted DiseaseU5MR Under 5 Mortality RateUNICEF United Nations Children’s FundUNCT United Nations Country TeamUNDP United Nations Development Programme

LIST OF CHARTSTrends & Targets for Absolute Poverty

Trends & Targets for Critical Poverty

Education Indicators:

Proportion of Pupils reaching Grade 5

Proportion of Seats held by women in

National Parliament

Trends & Targets for IMR, U5MR and

Immunisation

Maternal Mortality


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ForewordRemarks by the Minister of Foreign Affairs, Guyana 5Remarks by the Resident Representative, UNDP 6

Introduction 8

Analysis of Level of Achievement of Goals/Capacity

GOAL 1: Reduction In Poverty & Extreme PovertySummary 111. Diagnosis & Tendencies 122. Challenges for Achieving Targets 123. Support Framework 134. Priorities for Development Aid 135. Monitoring Capability 13

Goal 2: Universal Primary EducationSummary 141. Diagnosis & Tendencies 152. Challenges for Achieving Targets 153. Support Framework 154. Priorities for Development Aid 155. Monitoring Capability 15

Goal 3: Gender Equity & Women’s EmpowermentSummary 161. Diagnosis & Tendencies 172. Challenges for Achieving Targets 173. Support Framework 174. Priorities for Development Aid 175. Monitoring Capability 17

Goal 4: Reduction in Child Mortality RatesSummary 181. Diagnosis & Tendencies 202. Challenges for Achieving Targets 203. Support Framework 204. Priorities for Development Aid 20 5. Monitoring Capability 20

Goal 5: Reduction in Maternal MortalitySummary 211. Diagnosis & Tendencies 222. Challenges for Achieving Targets 223. Support Framework 224. Priorities for Development Aid 225. Monitoring Capability 22

Goal 6: Reduction in HIV/AIDS, Malaria and Other Diseases

Summary 231. Diagnosis & Tendencies 232. Challenges for Achieving Targets 233. Support Framework 244. Priorities for Development Aid 245. Monitoring Capability 24

Goal 7: Guaranteeing Environmental SustainabilitySummary 251. Diagnosis & Tendencies 262. Challenges for implementation of a sustainable development strategy 263. Support Framework 264. Priorities for Development Aid 275. Monitoring Capability 27

Goal 8: Creating a Global Partnership for DevelopmentSummary 281. Diagnosis & Trends 292. Challenges for the creation of a global development partnership 293. Support Framework… 294. Priorities for Development Aid 295. Monitoring Capability 30

Appendicesa. Guyana’s Progress towards the MDGs:

Status at a Glance 31b. Monitoring and Evaluation Capacity for

Tracking MDGs: 32

TABLE OF CONTENTS

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FOREWORDFOREWORDFOREWORDFOREWORDFOREWORD

RRRRRemarks by the MMMMMinister ofFFFFForeign AAAAAffairs, GGGGGuyana

I welcome the opportunity to present on behalf of the Government and people of Guyana this first Report,by Guyana, on its activities in the pursuit of the Millennium Development Goals that were agreed to at theMillennium Assembly of the United Nations.

On that occasion, leaders or their representatives of virtually all the nations of the world determined thatcertain fundamental objectives needed to be addressed as a matter of high priority and with some senseof urgency if the global community were to survive during the 21st Century. The Millennium Assemblybrought the world face to face with the seemingly inevitable consequence of abject and dehumanizingpoverty, with the wretchedness that accompanies the scourge of war and with the very real threats to ourvery survival, as a global community, through selfish and thoughtless environmental practices.

This Report is intended to reflect the early results of Guyana’s commitment to the Millennium goals.This first Report on the progress being made by Guyana reflects as much our achievements inrespects of the Millennium Development Goals as they re-emphasise the continuing commitment of theGovernment of Guyana to addressing the human, social and economic concerns of the people ofGuyana. For Guyana, these issues and the Millennium Development Goals that have been derivedfrom them, must therefore be seen in the context of Guyana’s own development priorities which arenow focused on the fundamentals of economic growth and the imperative for the maintenance of socialcohesion in these troubling times.

The Report, it must be clearly stated, needs also to be read and understood in a context, whichrecognizes that factors external to Guyana will have an impact on the pace with which the MillenniumDevelopment Goals are achieved, notwithstanding the very serious and committed efforts being madeto attain them. Guyana’s economy needs to grow at a steady and predictable pace, in excess of sixpercent (6%) per annum, if there is to be any realistic hope of achieving the targets set through theMillennium Declaration. The opportunities for development however, as for example those repre-sented by the globalization process, are unfortunately still eluding the grasp of many developing coun-tries. The more vulnerable among them, Guyana included, continue to experience difficulties inattaining sustainable economic growth even as the many protectionist barriers either are slowly beingdismantled or remain selectively in place and discriminately applied. Additionally, the threats to interna-tional peace and security are also likely to impede our efforts at reaching these targets.

Despite these many challenges that Guyana as a small developing country faces today, I remainconfident that considerable progress will continue to be made in overcoming them in the years ahead.

The Honourable Rudolph Insanally O.R, C.C.H., M.P.Minister of Foreign AffairsGuyana

Honourable Rudolph InsanallyMinister of Foreign Affairs


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RRRRRemarks By The UNemarks By The UNemarks By The UNemarks By The UNemarks By The UNRRRRResident Coordinaesident Coordinaesident Coordinaesident Coordinaesident Coordinator/tor/tor/tor/tor/RRRRResident Resident Resident Resident Resident Representepresentepresentepresentepresentaaaaativetivetivetivetiveof undpof undpof undpof undpof undp

Throughout the 1990s, goals and targets in key development areas were set at inter-national conferences and world summits. At the end of the last decade, world leadersdistilled the main goals and targets that had been separately established into onegrouping commonly referred to as the Millennium Development Goals (MDGs).

These goals are specific, measurable targets for the reduction of extreme poverty,improving health, education and environmental sustainability and establishing a glo-bal partnership for development. The goals and the commitments given by both thedeveloping countries and donor countrieswere affirmed in the Monterry Consensusthat emerged from the March 2002 UN Financing for Development Conference, theSeptember 2002 World Summit on Sustainable Development and the launch of theDoha Round on International Trade.

The Monterrey conference established a compact between rich and poor countriesin support of the shared Development goals. That commitment formed the basis ofthe Millennium Development Compact proposed by the 2003 Human DevelopmentReport. This Compact proposes a agenda through which the world community canwork together to help poor countries achieve the MDGs. It calls on all stakeholders toorient their efforts towards ensuring the success of the Goals, in a system of shareresponsibilities.

The Compact calls on all stakeholders to reorient efforts to achieve success, so that:poor countries can insist on increased donor assistance and better market accessfrom rich countries. Poor people can hold their politicians accountable for achievingthe poverty reduction targets within the specified timetable. And donors can insist onbetter governance in poor countries and greater accountability in the use of donorassistance.

Despite all the promises and commitments, it is evident that some countries will notachieve the MDGs. Estimates reveal that the average proportion of the population indeveloping countries living below $1 per day fell from 32 to 26 percent between 1990and 1998. The simple extrapolation of this trend to the year 2015 results in a head-count index of about 17 percent, suggesting that the world is on track to reach theglobal goal of reduction of extreme poverty by 2015. Unfortunately, the situation ismore complicated than this.

When East Asia is excluded, income poverty declined less dramatically, from 35 per-cent to 33 percent, and progress was less than half the rate needed to reach the

Jan Sand SorensenResident Representative/

Resident Coordinator

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poverty goal in the desired time frame. The number ofincome poor in sub-Saharan Africa, South Asia andLatin America combined, actually increased by about10 million each year between 1990 and 1998. Thus,the simple extrapolation of global trends to 2015 isinvalid, and global poverty projections will only be mean-ingful if they are based on country-specific projectionsand sufficiently disaggregated to reveal the variouscomponents of poverty.

Progress towards other MDGs has been mixed as well.In 1990, the global target of universal basic educationby the year 2000 was established. The good news isthat the gender gap in education has been halved,although it remains a concern in many countries insub-Saharan Africa, South Asia, the Middle East andNorth Africa. But the sad truth is that the 1990s sawonly a tenth of the progress needed to achieve univer-sal basic education. Therefore, it is not surprising thatthe goalpost was moved to 2015, but at the currentrate, this promise, too, will not be kept.

Progress on immunization, under-five mortality, mater-nal mortality, child malnutrition, access to safe drink-ing water and adequate sanitation has been too slow,and the agreed targets have not been met. In fact,what is most worrisome is that global progress duringthe 1990s slowed compared to earlier decades. Asthe 1980s have been called the “lost decade for devel-opment”, so the 1990s can be designated the “decadeof broken promises” and the decade of the cataclys-mic rise of the HIV/AIDS epidemic, with its attendantimplications.

As observed by the late Jim Grant (UNICEF ExecutiveDirector, 1993), “The Problem is not that we have triedto eradicate global poverty and failed; the problem isthat no serious and concerted attempt has ever beenmade.” Indeed, without concerted and intensified ef-forts, few of the MDGs will be met by 2015 at the globallevel. These efforts must include raising awarenessabout the MDGs and advocating energetically for con-crete actions to achieve them.

Meeting the Goals in Guyana, as in other countries,should start with the recognition by all stakeholders

that it must pursue a development strategy that meetsits specific needs. National strategies must be basedon solid evidence, good science and proper monitor-ing and evaluation. Within these bounds Guyanashould have the freedom to negotiate with donors todesign locally appropriate policies. Without true own-ership, national programmes will be neither appropri-ate to local conditions nor politically sustainable. Na-tional programmes must also respect human rights,sport the rule of law and commit to honest and effec-tive implementation. When these conditions are met,Guyana should be able to count on much more assist-ance from rich countries both in finance and in fairerrules of engagement for trade, finance and scienceand technology.

The national MDG reports give meaning to the globalgoals. Country reports on progress towards the MDGscan accelerate progress by raising public awareness,forging stronger alliances, and renewing political com-mitment. They can also help build national capacityfor monitoring and reporting. Such reports show MDGprogress at a glance in an effort to focus the nationaldebate on specific development priorities, and this, inturn, will hopefully trigger action in terms of policy re-forms, institutional change, and resource allocation.For this reason, the audience for this country report, asfor all other country reports, includes the media, politi-cians and the general public.

The production of this MDG Report on Guyana is justthe beginning of a process that we must work at toachieve success. The promise this Report offers willbe realized if it becomes a tool for consensus building.There needs to be a meeting of minds on the goals,the process of achieving and measuring progress; andas well a sense of ownership and equity among allstakeholders. The MDGs and the Compact, provide agood base for accountability and hence for develop-ment. The UN System therefore gives its unreservedsupport for the achievement of these goals

Jan Sand SorensenResident Coordinator/Resident RepresentativeUnited Nations Development ProgrammeGuyana


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Guyana faces three challenges in its effort to achieve the eightMillenium Development Goals: its poverty; its economic un-derdevelopment; and its vulnerability to economic, environ-mental, and social hazards.

PPPPP O V E R T YO V E R T YO V E R T YO V E R T YO V E R T Y

Poverty in Guyana is not merely income poverty. Instead, itmanifests itself as, and stems mainly from, constraints on thechoices that can be made at the national, regional, communityand individual levels. These constraints both result from ourpoverty and influence the other two challenges of underdevel-opment and vulnerability.

The GDP per capita in Guyana is no more than US$783, andyet, contrary to the traditional view that this figure is understateddue to the existence of a large informal sector, it can be arguedthat it is inflated by the comparatively high government ex-penditure relative to other countries with larger, more denselydistributed populations.

EEEEECONOMICCONOMICCONOMICCONOMICCONOMIC U U U U UNDERDEVELOPMENTNDERDEVELOPMENTNDERDEVELOPMENTNDERDEVELOPMENTNDERDEVELOPMENT

Guyana’s economic performance remains dependent on afew primary commodities.

Despite a number of far-reaching economic reforms in theearly 1990s, the economy has still not been able to achieveincreased competitiveness in its key sectors, or to strengthenthe economic and legal infrastructure to facilitate investmentand growth. Nonetheless, in the period 1992 to 1997, thereforms, which led to some foreign investment, the recoveryof export-oriented production, and arguably, the reintegrationof aspects of the parallel economy, were largely responsible

for the 7% annual GDP growth realised.

The country’s narrow export base makes it highly vulnerableto negative trends in the prices of its top commodities. By theend of the 1990s, two-thirds of export earnings still came fromthe four primary commodity exports: sugar (25%), gold(22%), bauxite (14%) and rice (10%). Although productionhad improved, markets (in terms of prices and volumesaccepted) had deteriorated, making the sectors still vulner-able: Guyana’s terms of trade deteriorated by 2 percent overthe second half of the 1990s. Agriculture and mining ac-counted for half of GDP, services one-third and manufacturingand construction one-sixth. Bauxite, forestry and gold re-mained the most attractive sectors for foreign investment dur-ing the 1990s, following which investment declined. Govern-ment’s efforts at exploring the eco-tourism sector as a growtharea have met limited success. Demonstrating the weak-ness inherent in the country’s narrow export base, reducedpreferential access to markets in Europe is expected to im-pact very negatively on Guyana’s export prospects, demand-ing a more competitive and diversified export sector.

VVVVVULNERABILITYULNERABILITYULNERABILITYULNERABILITYULNERABILITY TOTOTOTOTO E E E E ECONOMICCONOMICCONOMICCONOMICCONOMIC,,,,,EEEEENVIRONMENTNVIRONMENTNVIRONMENTNVIRONMENTNVIRONMENTALALALALAL ANDANDANDANDAND S S S S SOCIALOCIALOCIALOCIALOCIAL H H H H HAZARDSAZARDSAZARDSAZARDSAZARDS

The focus of interventions should be on managing thevulnerabilities posed by the economic, environmental and so-cial realities of Guyana. According to studies* done on thestructural and institutional weaknesses of developing coun-tries these vulnerabilities can be defined as follows:

1. The risk posed by exogenous shocks to systems ofproduction, distribution and consumption, or “economicvulnerability”.

The main source of these arguments is “Vulnerability and Small Island States” by a Research Team from the University of the West Indies Centre for Environmentand Development.

*

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2. The risk of damage to the country’s natural ecosys-tems, or “environmental vulnerability”; and

3. The degree to which social cohesion is negativelyaffected by stresses and threats from external forcesor intrinsic factors (internal and external), or “socialvulnerability”.

These combined obstacles to sustainable development tendto characterise the group of countries called “small islanddeveloping states” (SIDS), a category which includes Guy-ana where most of the developed coastline, in which the ma-jority of the population lives and works, is below mean high tidesea level. All SIDS countries face the threat of global warmingthrough climate change and sea level rise. Their particularvulnerability was codified in Agenda 21 as a “special case”, arecognition which was later expanded upon at the United Na-tions Global Conference on the Sustainable Development ofSmall Island Developing States held in Barbados, and theProgramme of Action adopted there. Most recently, at theMillennium Summit in 2000, world leaders resolved as fol-lows:

… to address the special needs of Small IslandDeveloping States, by implementing the BarbadosProgram of Action 5 and the outcome of the twenty-second special session of the General Assemblyrapidly and in full. We urge the international com-munity to ensure that, in the development of a vul-nerability index, the special needs of SIDS are takeninto account.

For the international community to live up to this call, it is impor-tant that the concept of vulnerability be fully developed and thatthe issues involved be ventilated, with alternative options con-vincingly argued. However, although this has not yet beendone, it is possible to propose a vulnerability index for Guy-ana, since the factors which make Guyana vulnerable in theeconomic, environmental and social spheres are self-evi-dent.

EEEEECONOMICCONOMICCONOMICCONOMICCONOMIC V V V V VULNERABILITYULNERABILITYULNERABILITYULNERABILITYULNERABILITY

The most visible shocks are on the processes of economicgrowth and economic development. External factors originat-ing from global commercial centres have led to serious insta-bility, and even threaten the existence of communities such asLinden and some rural agricultural villages.

In addition to the problems of economic underdevelopment,there is the problem of debt servicing: although the level ofGuyana’s external debt is not high in absolute terms, the levelof debt service payment was determined to be unsustainablyhigh in relation to the export earnings and the GDP of the

country. Under a programme agreed upon by the IMF andIDA in 1997, Guyana is to receive debt relief that would reduceits external debt by 25 percent in net present value (NPV)terms, as long as it continues its adjustment and reform efforts.The goal is to reduce the NPV of debt-to-government rev-enues ratio to 280 percent by the completion point of the HighlyIndebted Poor Countries (HIPC) initiative. This is intended toput the country in a sounder fiscal position while simultane-ously increasing expenditures on social sector objectives -mainly health, education, and social safety nets - from 8.4percent of GDP in 1997 to 12.7 percent of GDP by 2002. Theproblem is that continuous borrowings and contingent publicsector liabilities continue to add to the stock of new debt, inorder to maintain investment levels. If the economy does notcontinue to grow, or worse, if there is contraction in the GDP,then what was deemed to be a sustainable position would nolonger be sustainable, requiring another round of Paris Clubnegotiations. With the current tensions in the world, rising oilprices, and the perilous state of the Guyana economy, this is alikely scenario.

In terms of GDP and exports, the volatility of the economy iscompounded by the limited investment in diversifying theeconomy, reduced donor assistance, the slow incorporationof ICT, and the pending loss of lucrative historical markets

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G U Y A N ASouth America


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without clearly elaborated strategies as to how to minimise theresulting loss of revenue and employment.

EEEEENVIRONMENTNVIRONMENTNVIRONMENTNVIRONMENTNVIRONMENTALALALALAL VULNERVULNERVULNERVULNERVULNERABILITYABILITYABILITYABILITYABILITY

The natural ecosystems (e.g. the continental shelf, wetlands,savannahs, forests, wetlands, fresh water, coastal zones, ma-rine resources and soils) are essential to providing servicesto the economy and society. Degradation in the quality of theenvironment’s resources lessens the level of service the en-vironment can provide to meet domestic needs and contributeto export earnings. Environmental resources are affected byboth natural and human hazards, including social behaviour.In addition to those outlined earlier, another factor compound-ing the volatility of the economy is the steady depletion of natu-ral resources by mining and agriculture.

External shocks in the area of the environment include thefailure of the international community to act on climate changeduring the 1990s; this was also a period when developmentaid underwent the greatest reductions since its inception in thelate 1940s although global economic expansion was at itshistorically highest level.

Further, Guyana’s environmental vulnerability is increasedby the fact that as mentioned earlier, it has only been able toattract investment for the extraction of natural resources. Tocompound this, international agreements dictate how naturalresources should be extracted without providing compensa-tion which recognises the opportunity costs of not utilizing theresources.

SSSSSOCIALOCIALOCIALOCIALOCIAL V V V V VULNERABILITYULNERABILITYULNERABILITYULNERABILITYULNERABILITY

While the social vulnerability caused by stresses from exter-nal or internal factors is no more endemic to Guyana than toother developing countries, Guyana is an example of a coun-try with a limited institutional capacity to confront these stresses.Large-scale emigration of skilled labour in the last two dec-ades has reduced institutional capacity and created a majorhuman resource and capacity constraint in all sectors, butparticularly in education and health, where more qualified teach-ers and a larger pool of health professionals at all levels arenecessary.

The country’s social vulnerability can be explained in terms ofa long list of factors, including the following:

1. Falling levels of participation in the labour force, cur-rently at some 55 percent, as well as growing unem-ployment and underemployment, especially amongyoung persons. The fall in labour force participation isparticularly significant among males.

2. Changing consumption patterns, particularly amongyoung people, whose aspirations are influenced bythe media.

3. Growing dependence on food imports to meet do-mestic needs.

4. Limited progress in developing and deploying scienceand technology to address common development chal-lenges; and

5. Rising criminal activity and drug use.

The net result of all this is the loss of social cohesion and ofcultural values and practices.

GGGGGOVERNMENTOVERNMENTOVERNMENTOVERNMENTOVERNMENT ANDANDANDANDAND G G G G GOVERNANCEOVERNANCEOVERNANCEOVERNANCEOVERNANCE

The responsibility to reverse the growing trend of vulnerabilitybelongs to the government. However, a major challenge willbe resolving conflicting advice and requirements regardingthe role of government and its corresponding size and struc-ture. Many more resources need to be allocated to analys-ing and evaluating the appropriateness of donor prescriptionsand conditionalities imposed on aid, with a view to determiningwhether or not these stipulations will make us more vulnerableor more resilient.

For example, case evidence confirms that despite the grow-ing recognition that the development challenge is different andmore difficult because of the peculiarity of Guyana, inter aliaas a SIDS country, this is seldom taken into account in donoragreements. The advice to privatise relatively small utilities(water, electricity, and communications) results in escalatingcosts of services, not only in Guyana but in a number of othercountries. High energy costs usually correlate with low wages.Given the unique nature of the electricity sector in SIDS coun-tries, there is need to consider whether a model developed forthe UK is the most appropriate for a small country. It can beargued that privatisation in small countries results in the equiva-lent of asset stripping, or converting investments to financeconsumption. Reducing the overall vulnerability of the countrywill require the governments of these countries to aggres-sively contest external advice and conditionalities that wouldreduce opportunities for exports/import substitution based onindigenous resources, among these, renewable energy. Theresearch team on SIDS cited earlier concluded that given thecapabilities of the private sector in most of SIDS, the minimalflow of FDI that is strongly linked to the perceived vulnerabilityof SIDS, and a limited market infrastructure which does not yetallow effective and efficient operation of market forces, govern-ments will have to play a greater – not a reduced – role tolessen the growing vulnerability of SIDS.

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Analysis Of The Level OfAchievement Of Goals,And Of Present CapacityTo Achieve Them

Reduction InPoverty AndExtremePoverty

Summary

Objective 1: Reduce by half, between 1990 and2015, the percentage of personswith incomes below a dollar per day(extreme poverty), i.e., reduce to22%.

Objective 2: Reduce by half, between 1990 and2015, the percentage of people whosuffer from hunger (poverty), i.e., re-duce incidence to 14%.

Performance Summary:! Poverty Headcount: 1990 – 43%, 1999 – 36%.! Critical Poverty: 1990 – 28%, 1999 – 19%.

Will the goal be met by 2015?Achievable if economic growth can be restoredto 5-6% per annum.

State of Support Conditions forAchievement of Goal:Commitment there; accelerated pace of reformneeded.

GOAL

1


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Trends and Targets forAbsolute and Critical Poverty

1. Poverty and Extreme PovertyReduction: Diagnosis andTendencies

When Guyana’s economy grew by 7 percent perannum during 1992-97, the share of the popula-tion living in absolute poverty dropped from 43percent to 36 percent, while the proportion of thoseliving in critical poverty fell from 28 percent to 19percent. Overall, the poverty gap declined from 16percent in 1992/3 to 12 percent in 1999. Since1997, economic growth has slowed at around 1percent as a result of poor weather conditions,reduced commodity prices for key exports andadverse industrial relations. It is vital that economicgrowth be restored to pre-1997 levels to preventslippage and to accelerate the pace of povertyreduction over the next 5-10 years. In the shortterm, the country’s Poverty Reduction Strategy(PRS) projects a restoration of growth to 3-4 per-cent by 2005, but determined efforts will have tobe made to achieve a growth rate of 6 percent totackle pockets of chronic poverty.

2. Challenges for Achieving theTargeted Reduction in Povertyand Extreme Poverty

The main challenges are to diversify the eco-nomic base, to improve the quality of jobs (the1999 Living Conditions Survey showed that 83 per-cent of persons in the poorest quintile were gain-fully employed), to stem the migration of the coun-try’s technical, managerial and professional per-

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sonnel, and to accelerate the pace of reformingthe economic and political structures to facilitateparticipatory, self-directed approaches which canresult in genuine empowerment. Building a socio-political climate that is conducive to investmentand acquiring the financial resources to supportthe PRS are significant hurdles that need to beovercome in the fight to eradicate absolute pov-erty.

3. Support Framework (Policiesand Programmes)

The PRS will focus on maintaining macroeco-nomic stability, pursuing sector policies to stimu-late production, modernizing the traditional eco-nomic base, and providing systemic support forprivate sector investment. In the area of govern-ance, efforts will be focused on institutional andregulatory reforms, public accountability, legal and

judicial reforms, meaningful community partici-pation in local government and the protection ofhuman rights. In the short to medium term, gov-ernment will improve the maintenance, quality andcoverage of sea defences, roads and drainageand irrigation systems. Over the longer term, pri-vate sector involvement in the provision of eco-nomic infrastructure will be encouraged. In addi-tion, provision of titles for land will improve accessto credit, especially for poorer farmers. Industrialestates will be established in rural regions to proc-ess agricultural products and engage in lightmanufacturing. These activities are expected toexpand production and create thousands of jobs,thus increasing national, household and individualincomes.

4. Priorities for Development Aid

In support of the PRS, the Government of Guyananeeds to secure financing of US$1 billion fromthe International Development Community. Do-nor support for the design of a comprehensivesocial safety net system, including income sup-plement and a voucher system for textbooks, ex-amination fees and other related education ex-penses for poor families will be pursued.

5. Monitoring Capability


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UniversalPrimaryEducation

GOAL

2

Summary

Objective: To ensure that by 2015 at least 97% of allchildren entering primary school achievegrade five education.

Performance Summary:Enrolment at the basic education level is 98%.

State of Support Conditions forAchievement of Goal:The fact that 97% of children enrolled reach grade 5indicates that conditions are favourable.Education Indicators

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1. Universal Primary Education:Diagnosis and Tendencies

Primary education is almost universal in Guyana withnet enrolment at 98 percent, and hardly any differencebetween boys and girls or between rural and urbanareas. Moreover, 97 percent of all children who enterthe first grade of primary school eventually reach gradefive. Despite the high enrolment rate, literacy amongthe 15-24 year olds was measured at 71% in 1990.

2. Challenges for Achieving UniversalPrimary Education

The main challenges are how to achieve universalcoverage and improve the quality of education nation-wide within a difficult socio-political and economicenvironment. Strategies will have to be devised to meetthe following objectives, on which the PRS will focus:reducing illiteracy, drop-out and repetition rates, re-taining trained teachers in the education system, re-viewing and revising the curricula, and improving teach-ing methodologies for effective learning.

3. Support Framework (Policies andProgrammes)

Policies will aim at reducing the level of overcrowding,instituting national standards in Mathematics and Eng-lish Language, restoring former levels of functional lit-eracy, reducing the proportion of untrained teachers tostudents, and emphasizing Science and Technologyat the primary level. Health and Family Life Education(HFLE) will also be promoted to foster tolerance, dis-cipline, respect for diversity, democratic values and

human rights. A human resources programme will bedeveloped to address the demand, supply and place-ment of teachers. An appropriate incentive system toretain teaching talents will be devised and existing ca-pacities will be upgraded.

4. Priorities for Development AidThe highest priorities are improving the quality of edu-cation by curriculum development, and training andmotivating teachers. The continuous recruitment ofGuyana‘s teachers to work overseas, especially in de-veloped countries, requires immediate attention. Com-pensatory agreements should be pursued betweenGuyana and those countries that actively recruit teach-ers from the country’s education system. There is alsoneed to continue improvements in the physical infra-structure - buildings and supplies - and for administra-tors and educators to become more results-oriented.



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GOAL

3Gender EquityAnd TheEmpowermentOf Women

SummaryObjective: Eliminate gender differences in

primary and secondary education, pref-erably by the year 2005, and in all otherlevels of education no later than 2015.

Performance Summary:Some progress recorded.

Will the goal be met by 2015?The objective has been met, thoughnot the overall goal.

State of Support Conditions forAchievement of Goal:Guyana is signatory to all the relevant internationalconventions and protocols.

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1. Gender Equity and theEmpowerment of Women:Diagnosis and Tendencies

Investment in reducing gender disparities in education,especially at the technical and vocational levels, is usu-ally expected to provide real choices for women withregards to marriage, family, work and life in general. Yet,although there is no major difference in female and maleenrolment in primary and secondary education in Guy-ana, this has not translated into real gains for women interms of jobs: the female unemployment rate at 14 per-cent was more than twice that for men (6 percent) in1999, while the respective rates in 1992 were 18 and 8percent. Girls and women also continue to have a lowlevel of autonomy in and control over their sexual andreproductive lives. In the area of male disadvantage, thedrop out rate of boys from the secondary level of educa-tion is increasingly evident and has become a cause forconcern and study.

2. Challenges for Achieving GenderEquity and the Empowerment ofWomen

At the level of policy-making, the failure to mainstreamgender into development planning is a major stumblingblock to the equal inclusion of women in public life: whatneeds to be taken into account, above all, is the over-whelming responsibility of girls and women for theunwaged work of household and family care, and howthis shapes their participation in the public sphere, in-cluding in employment and institutions of governance.Gender mainstreaming in development planning is alsonecessary to fully address male under-performance ineducation. In addition, rising incidences of domestic vio-lence against women and children pose a critical chal-lenge.


Three actions are needed to strengthen the support frame-work for achieving gender equity and the empowermentof women:a. Working to change negative tendencies in the

socialization of boys and girls, through both the for-

mal and non-formal education system.b. Mainstreaming gender, and towards this end, im-

proving the quality of gender-disaggregated data.c. Making specific interventions in two areas, one, to

retain boys in secondary schools and two, to ad-dress domestic violence.


Priorities are improvements in capability at two levels: (a)in data collection and analysis in the sector Ministry andat national planning level; and (b) in the use of data inanalysis and decision-making



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ReductionIn ChildMortalityRates

GOAL

4

Summary

Objective:Reducing child mortality rates (boys and girls under5), by 2/3rds between 1990 and 2015.

Performance Summary:A gradual decline in reported rates is evident, but theserates are still too high and trends cannot beascertained.

Will the goal be met by 2015?Unlikely.

State of Support Conditions forAchievement of Goal:On the coast, physical facilities cannot accommodatethe volume of patients; in the hinterland, staff skills arelow; in both areas, staff numbers are inadequate.

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Trends and Targets for IMR, U5MRand Immunisation


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1. Child Mortality Rate: Diagnosisand TendenciesThe infant mortality rate was 65 per 1000 in 1986,decreased to 54 per 1000 in 1997, and is pro-jected to fall to 22 per 1000 in 2015. On the otherhand, the under-5 mortality rate seems to be veryvariable: at 90 per 1000 in 1985 declining to 49.6per 1000 by 1990, increasing to 54 per 1000 in2000 and is projected at 31 per 1000 in 2015. Inspite of these reported improvements, the ratesremain too high, and data show that communica-ble diseases contribute significantly to morbidityand mortality. The PRS will see the introduction ofthe Integrated Management of Childhood Ill-nesses (IMCI), the promotion of “baby friendly”programmes and accelerated immunisation pro-grammes, especially in hinterland areas.

2. Challenges for Achieving theTargeted Reduction in ChildMortalityChallenges include the need for training and re-tention of suitably qualified health care providers,and for the effective management of the logisticalrequirements of maintaining adequate suppliesof drugs and other medical aids to health facili-ties, especially in the deep rural and riverain ar-eas. The extension of coverage to residents wholive in remote districts will require creative solu-tions, given available budgetary resources. Im-proving the image of the public health sector as aprovider of quality health services will requiremechanisms for monitoring community-basedservices.

3. Support Framework (Policiesand Programmes)Health facilities will be rationalised where neces-

sary. In addition, the diagnostic capacity of healthcentres and district hospitals will be upgraded,and regional disparities will be addressed throughspecific interventions. Trained medical person-nel will visit health centres in the interior and diffi-cult-to-reach regions on a regular basis to provideprimary health care (PHC). There will be increasedsupport for mother and child programmes andimproved radio and other communication net-works to make maximum use of available healthcare resources.


The priorities are human resources development,and technical assistance to upgrade operatingsystems such as protocols for case management,patient care, treatment regimes, and materialsmanagement.


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Reduction InMaternalMortality

GOAL

5

Summary

ObjectiveReduce maternal mortality rates by 3/4 between1990 and 2015.

Performance SummaryUnclear, given the weak data collectioncapacity.


State of Support Conditions forAchievement of GoalPoor, attributable to the low GDP and consequently,to inadequate institutional care facilities.


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1. Maternal Mortality Rates:Diagnosis and Tendencies

There was a reported decline in maternity mortalityrates (MMR) from 230 per 100,000 live births in 1995to 122 per 100,000 live births in 2000. To meet thegoal, the rate needs to fall to 60 per 100,000 in 2015.The present reported rate, which is still unacceptablyhigh, exists in spite of the fact that according to avail-able data, more than 80 percent of women are at-tended at childbirth by trained medical personnel.

2. Challenges for Achieving theTargeted Reduction in MaternalMortality

One of the main challenges will be the provision ofgood quality and reliable information. This informa-tion will have to be disseminated to the population soas to empower communities to take responsibility fortheir health status. In addition, however, a compre-hensive reduction in maternal mortality would requiresocietal changes related to poverty reduction and theHIV/AIDS epidemic, as well as improvements in healthcare and education and adherence to appropriate

maternal care protocols by health workers.


Serious changes are proposed for the health sector.The Health Sector Reform Programme targets the is-sues of effectiveness, quality, efficiency, equity,intersectoral collaboration, community participationand financial sustainability. Some of the features ofthe programme are decentralisation of health deliveryfunctions, development of a basic package of serv-ices, and emphasis on PHC and community partici-pation. In addition, the PRS targets the full implemen-tation of the Medical Termination of Pregnancy Act.Greater attention will be given to the provision ofcounseling services, especially for the prevention, careand treatment of HIV-infected women. Referral cen-tres will be established to handle high-risk cases andaccess to quality reproductive health care will be im-proved.


Support for universal coverage and the extension ofreproductive health services to poor communities iscritical. In addition, training, awareness raising andupgrading of obstetric facilities are important.


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ReductionIn Hiv/Aids,Malaria andOther Diseases

GOAL

6

Summary

Objective 1: Reduce the incidence of HIV/AIDSby half and begin to reverse itspropagation by 2015.

Objective 2: Reduce the incidence of malariaand other endemic diseases by halfand begin to reverse theirpropagation by 2015.

Performance Summary:Inconsistent achievements, with reversals. Trendindeterminate due to Data inadequacies.

Will the goal be met by 2015?Unlikely

State of Support Conditions forAchievement of Goal:Inadequate, attributable to the low GDP, with severalconsequences, including for public health facilities.

1. HIV/AIDS, SexuallyTransmitted Diseases andEndemic Diseases: Diagnosisand Tendencies

Incidence rates for HIV/AIDS, Sexually-Transmit-ted Diseases (STDs) and endemic diseases areall high: reasons may vary between diseases, andinclude environmental issues, internal migrationfor jobs, the need for improved education on spe-cific health issues, and the need to changebehaviors and lifestyles. Thus, it will take manyyears before action results in any measurable im-pact on incidence rates. At the level of public healthfacilities there is need for early detection and man-agement by trained personnel, the strengtheningof surveillance capability, and the use of manage-ment protocols.

2. Challenges for Achieving theTargeted Reduction in HIV/AIDS, STDs and EndemicDiseases

Challenges include helping people to translateknowledge into life-saving behaviors, targeting and


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tracing affected persons, providing prompt STD/HIV treatment, and developing new strategies forcontrol.


Strategies for the general improvement of thehealth sector include the extension of health careservices, improvement of health facilities, the es-tablishment of a health insurance scheme, andmeasures to address inequalities in access tohealth and for the provision and delivery of serv-ices to vulnerable groups. However, specific meas-ures to address HIV/AIDS, malaria, filaria and tu-berculosis are not comprehensive, nor is therethe capacity for implementation.


Formulating and implementing comprehensivenational plans to address these illnesses are keypriorities. Reducing poverty and improving thestandard of living are major factors in the controlof communicable diseases, as they are for meet-

ing other goals. Priorities must include improvingaccess to quality care, implementation of provenstrategies such as PHC and health promotion, im-provement in public health management such aswaste disposal and clearing waterways, and pub-lic education. Special resource allocations for thecare and treatment of persons affected with HIV/AIDS will be essential.


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GuaranteeingEnvironmentalSustainability

GOAL

7

Summary

Objective 1: Integrate sustainable developmentprinciples into the country’s policiesand programmes, and reverse theloss and degradation of environmen-tal resources.

Objective 2: Reduce by half the proportion ofpeople without access to potablewater between 1990 and 2015.

Objective 3: Make significant improvements inthe lives of people who live in low-income and threatened neighbour-hoods by 2020.

Performance Summary:Inconsistent achievements, with reversals.

Will the goals be met by 2015?For objectives 1 and 2, likely. Objective 3 not likely

State of Support Conditions forAchievement of Goal:A legal framework exists in the form of the Environ-mental Protection Act. Policymakers are aware of theneed for conservation to sustain national output. Therehas been considerable investment in environmentalprojects, including the Iwokrama Rainforest Project. Acomprehensive disaster management Strategy is notyet in implementation.


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1. Environment and SustainableDevelopment: Diagnosis andTendencies

Guyana possesses considerable natural resourcesand vast biodiversity. It is very vulnerable to environ-mental shocks as production activities depend on theremoval of forests, mineral resources, and the protec-tion of land from incursion and erosion from the sea.There is a high risk of environmental degradation. It istherefore essential that the country pursue environ-ment-friendly conservation practices in order to sus-tain national well being.

In the water sector, the PRS envisages the expansionof the number of wells serving hinterland communi-ties, rehabilitation of major and minor water systems,improvement in the regulatory framework of the sector,charging fair prices to encourage the economical useof water resources, and pursuit of economies of scalein water production and distribution so as to reduceproduction costs, mount a public awareness campaignto educate families to conserve and treat water, andimplement a comprehensive maintenance plan.These actions will provide quality water to 95 percentof the population by 2010.

In low-income communities, the provision of housingwill be a major intervention. Squatting areas will beregularized in an effort to reduce the incidence of squat-ting and promote rational land use. Once regularized,these squatting areas will be upgraded to housingschemes and provided with basic infrastructure and

services. A Low Income Housing Revolving Fund hasbeen established to provide financing to low-incomeearners. Government will accelerate the distributionof house lots and land titles.

2. Challenges for theImplementation of aSustainableDevelopment Strategy

The key task will be the sustainable exploitation ofnatural resources to improve incomes, reduce povertyand improve the standard of living, while maintainingenvironmentally-friendly policies that preserve thehealth and well-being of the population, the resourcebase, the unique habitats and the delicate ecosystems.In water, finding long-term sources of potable water tomatch demand will be a major hurdle in providing af-fordable water to the population. In low-income com-munities, the major challenge will be the provision ofhousing that meets basic living standards.

3. Support Framework(Programmes and Policies)

The current Environment Protection Act (EPA) and thepreparation of the National Environmental Action Planprovide a reasonably sound framework for the sustain-able use of natural resources. Enforcement of the Planand of the provisions of the EPA, promotion of a publiceducation programme to alert the population to thebenefits of sound environmental policies, and the in-volvement of local communities in the management

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of ecosystems, will be major planks of programmesand policies in the sector.

Comprehensive strategies and planning frameworksfor the provision of housing and water are being imple-mented, although in an environment where resourcesare very limited. In addition, there are programmessuch as SIMAP that support special interventions inareas of chronic poverty. There is need however, for acomprehensive disaster management framework tobe introduced to address the vulnerability of some com-munities, especially those that are prone to floods anddrought.


Support is needed for targeted interventions in areaswith chronic levels of poverty, the performance of envi-ronmental audits and the implementation of a nationalprotected area system. Training of sufficient techni-cal personnel to provide a critical mass to performmonitoring and evaluation, as well as regulatory activi-ties, is also important.



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Creating A GlobalPartnership For Development(This is a global goal, towards which each countrymust meet national objectives).

GOAL

8Summary

Objective 1: Develop an open commercialfinancial system, based on ruleswhich areforeseeable andnon-discriminatory, and which willreduce debt to sustainable levels.

Objective 2: Develop and implement strategiesfor decent and productive work foryoung people.

Objective 3: Provide access to affordabletechnologies and scientificadvances (ICTs, inexpensivemedicines).

Performance Summary:Some progress, but recent reversals.


State of Support Conditions forAchievement of Goal:Not completely within national control.

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1. Global Partnership for Development:Diagnosis and Trends

Beginning in mid-1988, Guyana initiated a comprehen-sive Structural Adjustment Programme (SAP) that allowedthe stabilisation of the economy and the generation ofconditions for growth. These reforms redefined the roleof the State, reoriented the economy toward the freemarket, and facilitated the expansion of trade and invest-ment with the international community. Actions were alsotaken to liberalise markets and to regulate the financialsystem. Given resource constraints, both human and fi-nancial, the economic strategy of the country has fo-cused on reducing debt to sustainable levels through theinstrumentality of debt forgiveness, debt rescheduling,debt write-offs, and debt buybacks. New borrowings havebeen made at more concessional terms. These effortshave met with some success and more recently throughthe HIPC initiatives, multilateral institutions have grantedsome concessions on external debt.

In the early stages, the severity of the SAP measures hada negative effect on employment and incomes. In par-ticular, the downsizing of the public sector and the con-comitant loss of jobs, the privatisation of State enterprises,coupled with the virtually jobless growth in the privatesector, reduced opportunities for young people, espe-cially school leavers and university graduates seekingwhite-collar jobs.

The infrastructural, regulatory and legal frameworks forthe penetration of ICTs are not in place. Compoundingthe problem is the high poverty level of the country, whichhas made access to ICT the privilege of a small elite.The creation of an enabling social environment, whichis based on human rights, equity and social justice, willbe critical for the achievement and sustainability of theMDGs.

2. Challenges for the Creation of aGlobal Development Partnership forDevelopment

There is a pressing need to improve salaries in order tobuild up a critical mass of skills which were lost andwhich continue to be lost in the continued out-migration:this must be seen as part of an enabling environment

where adequate compensation becomes a sine quanon for attracting, training and retaining needed skills.

(Cf Introduction) Developments on the internationaltrading arena threaten national viability and survival.The markets for bauxite, sugar and rice have comeunder severe pressure as prices and conditions be-come less and less favourable. However, even asthese threats present real challenges, globalisationoffers prospects and promises of expanded markets,access to technology, and the ability to provide andsell services through the Internet network. The coun-try needs to gear up to meet these challenges by im-proving health, education and training, and infrastruc-ture. Issues of governance also need to be addressed.


There are no comprehensive and coherent strategiesto address the challenges of globalisation, opportuni-ties for youths and the rapid introduction and adoptionof new technologies. The architecture of the financialsector is inadequate for modern business, althoughthe regulatory framework is consistent with interna-tional standards.


The urgent need for the formulation of national plansfor the acquisition and adoption of new technologies,particularly ICT, the provision of opportunities for youths,and the development of an investment code and guide,is self-evident. The governance climate also needs tobe urgently addressed to increase confidence in theeconomy and provide the stability needed to produceincreased investments, the increased availability ofskills, economic growth and poverty reduction. Thisshould be enhanced by facilitating the involvement andparticipation of all stakeholders in decision-making,making possible a sense of ownership in strategy andprogramme design and implementation. In the arenaof politics, relations of conciliation and mediation needto be cultivated. The donor and lender communityshould become strategic partners in Guyana’s devel-opment. This is especially critical as the shortage ofnational and aid resources becomes more severe.Such an approach will facilitate the following:


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a. Guyana’s adoption of a proactive stance inthe international arena.

b. Guyana’s continued access to concession-ary financing for strategic national economicinvestments, which are not covered under theHIPC-funded PRS, and the achievement ofdesired results.

c. The implementation of a new framework forinternational cooperation to foster the growthin and availability of aid resources directed tosupporting the objectives of the PRS; and

d. The incorporation into the bilateral discus-sion agenda of issues related to the openingof markets and free trade treaties, for the pur-pose of giving long-term sustainability to thedevelopment policies contained in the PRS.

The revision and increase of preferential arrange-ments, as well as the elimination of restrictive tradepractices and the promotion of fair trade, shouldalso be areas of focus.

It is insufficient to restrict the benefits of improvedforeign relations and support from the internationalcommunity to aid, funding and foreign investments.A major reason for this is that one of the structuralsolutions to the problems of sustainability in thedevelopment process in Guyana, is the openingof markets, especially in the more developed coun-tries.


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UniversalPrimaryEducation

Gender EquityandEmpowermentof women

MaternalMortality

Reduction inHIV/AIDS,Malaria andother Diseases

EnvironmentalSustainability

Global Partnershipfor Development

Appendix A

Guyana’s Progress towards the MDGs: Status at a Glance

GOALS OBJECTIVE LIKELHOODOF ACHIEVINGGOAL

Poverty Extreme PovertyHalve the proportion of peopleliving below the national poverty line by 2015 Potentially Weak, but improving

Hunger: Halve the proportion of people whosuffer from hunger between 1990 and 2015 Potentially Weak, but improving

Ensure that by 2015 at least 97 percent of allchildren entering primary school achievegrade five education Probably Strong

Ensure equal access for boys and girls toprimary and secondary by 2005 and to alllevels of education by 2015 Probably Strong

Child Mortality Reducing child mortality rates by two-thirdsbetween 1990 and 2015 Unlikely Weak

Reduce maternal mortality rates bythree-quarters between 1990 and 2015 Unlikely Weak

Reduce the incidence of HIV/AIDS by halfand begin to reverse its propagation by 2015. Unlikely WeakReduce the incidence of malaria and otherendemic diseases by half and begin toreverse their propagation by 2015. Unlikely Weak

Integrate sustainable development principlesinto the country’s policies and programmes,and reverse the loss and degradation ofenvironmental resources Potentially Weak but improvingHalve the proportion of people without accessto potable water between 1990 and 2015 Potentially Weak but improvingImprove the lives of people who live inlow-income and threatened neighbourhoodsby 2020 Potentially Weak but improving

Open Commercial financial system, based on ruleswhich are foreseeable and non-discriminatory andwhich will reduce debt to sustainable levels Potentially WeakStrategies for decent and productive work for youngpeople Potentially WeakAccess to affordable technologies and scientificadvances (ICTs, inexpensive medicines) Potentially Weak

STATUS OFSUPPORTCONDITIONS


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Appendix B

Guyana’s Monitoring Capacity for Tracking the MDGs: Status at a Glance

Goals DataCollectionCapability

Poverty Weak Good Weak Weak Weak Weak

Hunger Weak Good Weak Weak Weak Weak

UniversalPrimary Education Good Good Weak Good Good Weak

Gender Equality Weak Weak Weak Weak Weak Weak

Child Mortality Weak Good Good Good Good Weak

Maternal health Weak Weak Weak Weak Weak Weak

HIV/AIDS Weak Weak Weak Weak Weak Weak

Malaria andother diseases Weak Weak Weak Weak Weak Weak

SustainableDevelopment Good Good Weak Weak Weak Good

Global Partnerships Good Good Weak Weak Weak Good

*This main source of these arguments is “Vulnerability and Small Island States” by a Research Team from the University of the West Indies Centre forEnvironment and Development.

StatisticalAnalysiscapability

Quality of theInformation inrecent polls

Statisticalfollow-upcapability

Capability forincorporationof statisticalanalysis intopolicies, plansand resourceallotmentmechanisms

MonitoringandEvaluationMechanisms

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