Guinea

En français

HKI has been working in Guinea since 2000. HKI’s eye health and nutrition programs in Guinea aim to reduce malnutrition and protect eye health through preventive interventions targeting vulnerable communities, households and family members. HKI supports government efforts to integrate these interventions into poverty reduction programs, and to develop policies to reduce malnutrition and mortality to facilitate the achievement of millennium development goals. Current activities include:

• Vitamin A Supplementation >>more
• Anemia Control and Prenatal Care >>more
• Food Fortification >>more
• Nutrition programs for those living with HIV/AIDS >>more
• Nutritional Surveillance and Rehabilitation programs >>more
• Food-based Approaches to Preventing Malnutrition >>more
• Onchoceriasis Control >>more
• Trachoma Control >>more

Program Descriptions:

Vitamin A Supplementation (VAS): Every year, vitamin A deficiency contributes to an estimated 9% of child deaths and 13% of maternal deaths. The goal of HKI’s nutrition program in Guinea is to reduce morbidity and mortality caused by vitamin A and other micronutrient deficiencies in children under-five years and in women of child-bearing age. HKI supports the government and partner organizations in institutionalizing micronutrient supplementation including bi-annual vitamin A distribution to children under-five, integration VAS, particularly for children aged 6-11 months, into routine health care, and postpartum VAS.

In 2005, HKI integrated VAS into National Polio Immunization Days (NIDs), and exceeded national VAS goals by reaching more than 2 million Guinean children. As NIDS were phased out in 2006, HKI, WHO and UNICEF worked with the Ministry of Health (MOH) to implement integrated Child Health Weeks, which reached over 90% of children under-five years. The children were provided with deworming medication and vaccination boosters in addition to vitamin A. HKI and UNICEF also helped the MOH prepare guidelines for routine VAS , developed training curricula, and implemented training for Ministry and NGO staff on vitamin A and other key micronutrients.

Postpartum VAS: HKI is providing institutional support to integrate post partum VAS into routine care provided by maternity and pediatric wards, hospitals, rural health centers and private health care providers. In collaboration with local partners, HKI designed new expansion strategies at the community level in Upper Guinea such as using traditional midwives and CDTI (the community based drug distribution program for onchocerciasis control).

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Anemia Control: Anemia during pregnancy contributes to an estimated 18% of maternal deaths and 23% of perinatal deaths. One of the first activities supported by HKI in Guinea was the design and implementation of micronutrient deficiency surveys to determine local knowledge, attitudes and practices related to anemia and vitamin A deficiency. Survey results indicated that 70% of pregnant women and 75% of children under five years old are anemic in Guinea. These results were used to formulate national anemia control strategies, and HKI is currently working with the MOH and the Ministry of Education to test and scale up two anemia control programs: one for pregnant women at the community level and one for adolescent girls in schools.

Prenatal Care: In collaboration with Africare and the MOH, HKI designed and tested an innovative nutritional support program for pregnant women that includes outreach prenatal care, the provision of an integrated package of services at the community level, and positive deviance peer educators (local mothers with healthy children who act as counselors for others). Results indicate that the approach is an effective way to reduce anemia during pregnancy, as well as to reduce overall morbidity during and after pregnancy. Anemia rates of participants are half of those of non participants even after supplementation, and half as many children born of participating mothers suffer from low birth weight. This approach was scaled up to additional regions of Guinea through innovative partnerships with existing projects, NGOs and government agents. To date, the approach has been implemented in 88 sites, and over 5,000 women have participated.

Food Fortification: HKI is a founding member of the National Food Fortification Alliance in Guinea. In 2003, a regional food fortification workshop was held in Conakry, with support from HKI, UNICEF, the West African Health Organization (WAHO) and the World Health Organization (WHO). During this workshop, the results of a national food fortification study were presented, and wheat flour was identified as the most economic and appropriate option for food fortification efforts in Guinea.

A national wheat flour fortification program was officially launched in August 2005 in collaboration with a private grain mill, Grands Moulins de Guinée (GMG), consumer groups and various government ministries. Since the program started, over 70,000 tons of wheat flour have been fortified with iron folate and B vitamins, sufficient to fortify over 150,000, 000 loaves of bread, and feed hundreds of thousands of local families. In 2006, legislation was enacted requiring all wheat flour sold in the country to be fortified with iron and B vitamins, and in 2007 the national legislation was launched with a national workshop, advocacy efforts, communication campaigns, rapid market assessments and integrated monitoring and evaluation efforts.

Nutrition programs for those living with HIV/AIDS: Approximately 1.5% of adult Guineans (15 – 49 years of age) are infected with HIV; however, the sero-prevalence rate, persons who tested positive for the virus, is two times higher in women than men. HKI is a leader in providing technical support to international and local NGOs as well as the World Food Program (WFP) to integrate nutritional care and counseling into existing programs designed to assist persons living with HIV/ AIDS.

In 2006, HKI staff trained over 150 health center staff members, hospital staff, UN, NGO and local organizations about the specific nutritional needs of people living with HIV/ AIDS. Trained partners support 3,000 people living with AIDS in Guinea. HKI staff in Guinea and Sierra Leone are collaborating with HKI’s Senegal office to modify HIV/AIDS nutrition tools and training modules developed in that country for local use, and to develop a manual for organizations providing nutritional support for people living with HIV/AIDS in Guinea.

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Nutritional Surveillance and Rehabilitation: Thirty-five percent of the children under-five in Guinea are chronically malnourished, and 9% suffer from acute malnutrition. HKI promotes and supports community-based growth monitoring efforts to encourage appropriate child health and nutrition practices to prevent malnutrition before it happens, and the rehabilitation of moderately malnourished children at the community level using local resources and knowledge. In addition, HKI provides training and equipment for the rehabilitation of severely malnourished children at regional hospitals, and the introduction of community-based rehabilitation of severely malnourished children who don’t have additional health complications at the community level. HKI has provided technical assistance to the Ministry of Health to develop a national nutritional rehabilitation policy for severely malnourished children and for children born to mothers who are HIV positive.

In 2007, HKI began working with Nutriset and local women’s groups to promote the local production of ready- to-use therapeutic food to facilitate community-based rehabilitation of severely malnourished children.

Food-based Approaches to Preventing Malnutrition: Vitamin and mineral supplements offer a short-term solution to a long-term problem. The promotion of a diversified and nutritious diet based on local foods is an essential component of Guinea’s national nutrition strategy. In collaboration with local partners, HKI supports the production and consumption of foods with high nutritional value, including orange fleshed sweetpotatoes and green leafy vegetables. In addition, HKI has helped local NGOs promote alternative sources of vitamins and minerals. Communication campaigns, musical events, theater, radio, cooking demonstrations and group discussions are used to promote a varied and nutritious diet, and community health volunteers use posters and story books to encourage improved nutritional practices. In the long term, a diversified diet, improved hygiene and control of nutrient-depleting diseases, such as malaria and hook worms, will lead to sustained improvements in the nutritional status of the population.

Onchocerciasis Control: HKI also works to control onchocerciasis (river blindness). In partnership with the National Onchocerciasis Control Program, HKI developed communication materials used by community volunteers to distribute ivermectin (Mectizan® )which is distributed free of charge, and donated by the pharmaceutical company Merck & Co, Inc. HKI works with local partners to support the distribution of other child health products including vitamin A, mebendazole (for deworming), and reproductive health products) using the same community health volunteers, with local partners, and supports reinforced supervision of and support for community health volunteers. A new reproductive health program using community-based ivermectin distributors is being funded by the World Bank.

Trachoma Control: In 2003, HKI launched a pilot project to prevent trachoma in the Kankan region of Upper Guinea where the disease affects one third of children under the age of 10. The project included training of health agents and community health volunteers in detecting trachoma and using antibiotics for treatment, as well as using the SAFE strategy (surgery, antibiotic treatment, face washing, and environmental change) to prevent the spread of the disease. A regional trachoma coordinating committee was created, and local religious and traditional leaders actively participated in the program. In 2008, HKI will support the integration of trachoma training modules into school health curricula.

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Program Partners

• Africare
• Association Guinean de Bien Etre Familial (AGBEF)
• Canadian International Development Agency (CIDA)
• Catholic Relief Services (CRS)
• Christian Children’s Fund (CCF)
• Engender Health
• Government of Guinea (Ministries of Health, Commerce, Education, Finance, Social Affairs, Agriculture and Interior)
• Institute of Nutrition and Child Health (INSE)
• Local NGO's including KDF, CESAD and AFPAMNIG
• Opportunities Industrialization Centers (OICI)
• National Nutrition Committee (NNC)
• Peace Corps
• PLAN - Guinea
• Save the Children-US
• School-to-School
• Student groups and associations
• UNICEF
• World Food Program (WFP)
• World Health Organization (WHO)
• USAID

Key Staff

• Jen Peterson - Country Director
• Epiphane Agossou - Administrative and Finance Manager
• Dr. Lanfia Touré - Upper and Middle Guinea Program Coordinator
• Aïssatou Toure- Micronutrient Program Officer
• Bah Mamadou Midiaou- Nutrition Technical Advisor
• Dr. Appolinaire Delamou - Nutrition Technical Assistant
• Aliou Bah - Nutrition Technical Assistant