Reduce infant mortality and improve maternal health (MDG 4 and 5)
Concerning the healthcare sector in general: - this sector represents, considering all the tools, an annual average expenditure of 185 M€ (2001-2003). France allocates 4% of its Development Aid to healthcare. These sums are broken down into 110 M€ (59%) for bilateral initiatives and 75 M€ (41%) for multilateral initiatives. A high level of variation was observed in 2002 with an initial contribution of 50 M€ to the Global Fund to fight AIDS, Tuberculosis and Malaria. The trend accelerated after the Evian G8 summit with the annual contribution rising to 150 M€ as of 2004, which positioned our multilateral engagements ahead of all our other engagements. Most of the resulting projects concern the deployment of sector based reforms and programmes on a deconcentrated basis. In addition, within the framework of the PPTE initiative, the first C2D represented an amount of 2.5 M€ dedicated to the healthcare sector in 2001- 2002.
For the 2001-2003 period, French aid in the healthcare sector was highly concentrated geographically: just 16 countries (out of 54 Priority Solidarity Zones - ZSP), received 75% of financing from the French Ministry of Foreign Affairs and the AFD. These were Morocco, Mozambique, Senegal, Mali, Madagascar, Togo, Burkina Faso, Cameroon, Ivory Coast, Gabon, Cambodia, Chad, Central African Republic, Djibouti, Niger and Rwanda. From this list, the first seven countries represented 50% of total financing.
With regards more precisely to the MDG concerning healthcare:
Child healthcare (MDG 4): priority actions concern vaccination, Integrated Management of Child Illness (IMCI) and prevention of neonatal mortality (related to intervention on maternal mortality). France contributes to financing the GAVI Alliance and envisages strengthening its contribution to the WHO/UNICEF programmes relative to child health. At the present day, this contribution notably represents a financial contribution of 30 M€ towards the plan for eradicating poliomyelitis.
Fight against maternal mortality and morbidity (MDG 5): France has developed expertise in the field of projects which contribute to defining principles for global care of pregnancy and reduction of foetal-maternal risks. Application of this expertise will be carried out in a limited number of countries along with the possibility of strengthening specialised technical expert assistance. Initiatives on this theme will carry a significant level of support for the training aspect.
Improve access to healthcare and the management of patients and their pathologies in Mali
In Mali, the FDA works in the healthcare sector within the framework of the Ten Year Health and Social Development Plan drawn up by the Mali government for the 1998-2007 period and which is aimed at improving access to healthcare for populations and improved management of their diseases and pathologies. FDA intervention is limited to the 5th region in the country where the healthcare situation is especially critical. Its objectives are as follows:
strengthening of healthcare coverage (construction of a regional hospital, a district hospital and 15 community health centres);
improvement of the quality of services throughout healthcare structures in the region;
reduction of cultural and financial barriers to access to healthcare through support for young women’s and youth associations and the development of mutual societies and local solidarity mechanisms,
building management capacities for deconcentrated services in the healthcare system and management capacities for decentralised local authorities; plus development of human resources through the construction of and operational for a paramedical school.
Prevention of maternal and infant mortality and the fight against HIV/AIDS in Bobo Dioulasso and Banfora.
In Burkina Faso the Foreign Ministry is active in the healthcare sector, on MDGs 5 and 6, via the project for prevention of maternal and infant mortality and the fight against HIV/AIDS in two regions. This project, for which the target population is pregnant women, provides for training of healthcare agents and the renovation of district maternity clinics. The AIDS component provides: support for associations fighting against AIDS: improvement in early detection and care for seropositive pregnant women and AIDS prevention by treating children at childbirth. The Maternity Without Risk structure provides support in reducing maternal mortality by detecting and caring for high risk pregnancies, fighting against poverty and establishing mutual healthcare prepayment systems with special support in rural areas.