Guinea (the Republic of Guinea) is a country along the Atlantic coast of West Africa. Approximately 42% of Guinea’s population of 13.5 million is under the age of 15 years old.
According to UNFPA, in Guinea, the maternal mortality ratio in 2017 was 576 deaths per 100,000 live births, and 44.7% of pregnant people delivered without a skilled attendant in 2020. The DHS reports the modern contraceptive prevalence rate for all women 15 to 49 in Guinea is 11%.
Our Work in Guinea
Since 2005, EngenderHealth has supported fistula prevention, treatment, and reintegration of clients into their communities in Guinea. Our first programs provided a foundation for expanded fistula prevention, case finding, referral, and treatment. Early in our work, we participated in developing Guinea’s national fistula strategy and worked alongside local governments to establish initiatives that prevent fistula. Today, our work builds off those early activities by supporting and expanding country efforts to strengthen surgical safety within maternal health and voluntary family planning programs.
From 2005 to 2019, EngenderHealth supported over 3,500 fistula repairs and trained obstetric clinicians in labor management, catheterization, and surgical delivery through the Fistula Care project. Our work in Guinea focused on a holistic approach that went beyond fistula repair to encompass prevention and reintegration services. We helped develop and implement innovative models for reintegration for clients with fistula, even for those deemed incurable. Together with our partners and local governments, we established village safe-motherhood committees in Kissidougou, Boké, and Labé, which play an integral role in fistula prevention. To ensure the sustainability of the program and to improve community and local government involvement in fistula prevention, treatment, and reintegration, we provided technical assistance and training to district governmental bodies, the Kissidougou District Hospital, the Ministry of Health, and the National Division of Decentralization.
EngenderHealth is now working with partners in the regions of Conakry, Kindia, Boké, Labé, and the prefecture of Kissidougou through the MOMENTUM Safe Surgery in Family Planning and Obstetrics project—a total of 1.14 million people live in supported areas. MOMENTUM Safe Surgery in Family Planning and Obstetrics partners with the Government of Guinea to accelerate progress toward strengthening surgical safety in maternal health care and preventing obstetric fistula. The project works with governmental partners and professional associations to identify and strengthen gaps in surgical team capacity to provide safe surgical obstetric care aligned with World Health Organization Guidelines and the safe surgery checklist, and to prevent and treat fistula. The project also provides technical support to the government to update, develop, test, validate, and implement quality improvement and social and behavioral change strategies with providers to optimize appropriate and high-quality cesarean delivery care. We have identified and addressed key equipment and supply needs through auditing operating theater equipment, procuring supplies, and are building the capacity of health facility staff to maintain surgical equipment and materials. As part of strengthening the safe surgery ecosystem, we have trained OB/Gyns, midwives, and anesthetists on the implementation of routine maternal and perinatal death surveillance and response systems, which can effectively help reduce future preventable mortality.
During 2022 and 2023, EngenderHealth has supported local partners to strengthen the availability of and access to holistic fistula care. Holistic fistula care begins with prevention and case identification, which we have strengthened through community outreach and education efforts and establishing community identification and referral systems for women with fistula. To improve the availability of high-quality clinical care for women with fistula, we have trained clinicians on surgical skills, nursing, and counseling. Those trainings are also an opportunity to provide surgical repairs for identified clients, in addition to routine repairs that may be carried out by supported health facilities. To ensure that women are successfully reintegrating into their communities post-surgery, we have revitalized a social immersion, through which women are connected with local host families who provide a caring and supportive environment and immersion in family activities. This reintegration includes skills development support, entrepreneurship training, and support activities to provide economic opportunities for women post-repair.
The MOMENTUM Safe Surgery in Family Planning and Obstetrics project works with partners in Guinea to strengthen safe surgery by scaling up proven practices, supporting safe and appropriate cesarean delivery; peripartum hysterectomy; and high-quality holistic fistula care. As part of the larger MOMENTUM suite, our aim is to improve the health and well-being of individuals, families, and communities with the ultimate goal of accelerating the reduction of maternal, newborn, and child death and disability.
Our Partners in Guinea
- Guinea Ministry of Public Health & Hygiene (Family Health Directorate; Community Health Directorate)
- Ministry of Social Affairs and the Advancement of Women and Children Guinean Society of Gynecology and Obstetrics (SOGGO)
- Guinean Association for the Fight against Obstetric Fistula/Mother and Child Health (AGFO/SME)
- Guinean Order of Midwives
- Guinean Order of Nurses