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FISCAL YEAR July 1 - June 30 MCH Mtderal and Child Haelth ME - MM6ad wn endeka I Entia Drg Mm FF Mnre d& l'econoea Ja nfma at dil I Minisr of FAMe NW Planng MO - Min y of ealth MPR MA- uwi"proa4&qaue MSPSF - Mbslsalra hit ll,c aciode sdc akde lakmd& I Mitry of Health, So CW Developmet and th Famy MST - M ainduas zuuae awran I Sexaly Tauaitd Dsee NGO - Non-Pgove ntal Orgniatio OCCGB - Orgw ar d ceoniltnaon aetds coeprusn pour la bc c L gmanduw and&a / Or1anizatod of Coordinato and Cooan for the Fight apgnt Mjr Endeic Di_a OCP Onchoceciaads Contl Pogam OCS - Organtrclion ommunauatr d saw I community Healt Orgaiaons OMS - Oryosak nondlal dc. 2.2 Infant mortality of 133 per 1,000 (1991) remains high even by SSA standards, where the average is 104 (1991).

A major contributing factor to this low life expectancy is high infant and child mortality caused by widespread cotious diseases, unfavorable hygienic conditions, malnutrition, and the limited capacity of the health system to preventhese conditions and to treat them effectively once contracted.

Public Disclosure Authorized ca AS5s t-a/ -)/a CURNCY OUIVLENT Curncy Unit = CFA Franc (CPAF) I US

FISCAL YEAR July 1 - June 30 MCH Mtderal and Child Haelth ME - MM6ad wn endeka I Entia Drg Mm FF Mnre d& l'econoea Ja nfma at dil I Minisr of FAMe NW Planng MO - Min y of ealth MPR MA- uwi"proa4&qaue MSPSF - Mbslsalra hit ll,c aciode sdc akde lakmd& I Mitry of Health, So CW Developmet and th Famy MST - M ainduas zuuae awran I Sexaly Tauaitd Dsee NGO - Non-Pgove ntal Orgniatio OCCGB - Orgw ar d ceoniltnaon aetds coeprusn pour la bc c L gmanduw and&a / Or1anizatod of Coordinato and Cooan for the Fight apgnt Mjr Endeic Di_a OCP Onchoceciaads Contl Pogam OCS - Organtrclion ommunauatr d saw I community Healt Orgaiaons OMS - Oryosak nondlal dc. 2.2 Infant mortality of 133 per 1,000 (1991) remains high even by SSA standards, where the average is 104 (1991). A major contributing factor to this low life expectancy is high infant and child mortality caused by widespread cotious diseases, unfavorable hygienic conditions, malnutrition, and the limited capacity of the health system to preventhese conditions and to treat them effectively once contracted.Public Disclosure Authorized ca AS5s t-a/ -)/a CURNCY OUIVLENT Curncy Unit = CFA Franc (CPAF) I US$1 = 270 CFAF (Rate prior to Janyary 12, 1994) Curmnt Rate = CFA Francl USSI = 580 CFAF WEIGHTS AND MEASURES Metric System I m. de sad pdmr I Primaq Health Care Post SA - Specal Accou SAFER - Soc#W ajhcbw d'icda a de Maksanom I Afica Firm for Stue sa Achievemnt Se P - Save the Childr Fund SPE - Sagqe mm d'di I Government Certified Mi A SIDA - Syndv me d'lmw Jfic cqids I AIDS SMI - Sawt mamelk aet infundk / Mote and Chld Heath SOEs - State of Expends_ SONAPHARM - Soc-M nanalk d'appavonmantph Iadque National Pharmaceul Supply Company SOSUCO - Soci Et acsq,v de Ia Como E I Como6 Company of Sugar Manufetus 3SP - Soins de sanapfar / Primary Health Care msu - Seually Trnmited Disea TDCI - Troubes Du ear Carncas an de Iodine Deficiency Diseses TRO - Ih Erapk de rfda"en par voe oral UCP - Unit d oorfinaton du projet 1 Project Coordini Unit UNDP - United Nations Development Programme UNFPA - Unitd Nations Fund for Populatn Acvies UNICEF - United Nations lntemaonad Children's Fund USAID - United Se Agecy for Inrnatinal Developm USC - Un W de souin des comosa VHW - Vllage Health Worker VITAL - Viamin A Fidd Support Project (JSAID) WHO - Wodtd Health O:anizaton WID - Women in Dealoment BURKINA EAS ', ALTH AND NUTRITON PROJECT fpdsn) TABLE OF CONTENTS Clr ET AND PROJCT SUMMARY...,.i I. 2.3 Maternal mortality is also high with 810 per 100,000 births (1988). toa a I World Health Oaiza OR - Opeationa Reseah OSr - Ofca de sang ha auvai&ers I Bureau of Worker' Health PASE - Pogramme dppa a la su4weillanca ipudhmlgi q I Epidemiological Surveillaem Support Proje At PCU - Proect Coordinang Unit PDDS - Pk ide &wlppain & dibct Wa E I Dit Healh Development Plan PDSN - Proj.: devloppamaude sawn ade nurton I Hea and Nuti Development Poject PDSS - Proj es 4 dioppamaemes * ansfa de sam / Health Serviea Deveowmen Project PEG - Prevuuona Lc conrak dha and es goelsr a I Training Comm. About 18% of babies suffer from insufficient birthweight which limits their canaces of survival. To address this risk, the Goverment has, prior to negotiations, developed a-d begun to implement an action plan, acceptable to IDA, to eosute the required redeployment and that the peonnel concerned reman where posted and carry out their assigned responsibilities.

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FISCAL YEAR July 1 - June 30 MCH Mtderal and Child Haelth ME - MM6ad wn endeka I Entia Drg Mm FF Mnre d& l'econoea Ja nfma at dil I Minisr of FAMe NW Planng MO - Min y of ealth MPR MA- uwi"proa4&qaue MSPSF - Mbslsalra hit ll,c aciode sdc akde lakmd& I Mitry of Health, So CW Developmet and th Famy MST - M ainduas zuuae awran I Sexaly Tauaitd Dsee NGO - Non-Pgove ntal Orgniatio OCCGB - Orgw ar d ceoniltnaon aetds coeprusn pour la bc c L gmanduw and&a / Or1anizatod of Coordinato and Cooan for the Fight apgnt Mjr Endeic Di_a OCP Onchoceciaads Contl Pogam OCS - Organtrclion ommunauatr d saw I community Healt Orgaiaons OMS - Oryosak nondlal dc. 2.2 Infant mortality of 133 per 1,000 (1991) remains high even by SSA standards, where the average is 104 (1991).

A major contributing factor to this low life expectancy is high infant and child mortality caused by widespread cotious diseases, unfavorable hygienic conditions, malnutrition, and the limited capacity of the health system to preventhese conditions and to treat them effectively once contracted.

Public Disclosure Authorized ca AS5s t-a/ -)/a CURNCY OUIVLENT Curncy Unit = CFA Franc (CPAF) I US$1 = 270 CFAF (Rate prior to Janyary 12, 1994) Curmnt Rate = CFA Francl USSI = 580 CFAF WEIGHTS AND MEASURES Metric System I m. de sad pdmr I Primaq Health Care Post SA - Specal Accou SAFER - Soc#W ajhcbw d'icda a de Maksanom I Afica Firm for Stue sa Achievemnt Se P - Save the Childr Fund SPE - Sagqe mm d'di I Government Certified Mi A SIDA - Syndv me d'lmw Jfic cqids I AIDS SMI - Sawt mamelk aet infundk / Mote and Chld Heath SOEs - State of Expends_ SONAPHARM - Soc-M nanalk d'appavonmantph Iadque National Pharmaceul Supply Company SOSUCO - Soci Et acsq,v de Ia Como E I Como6 Company of Sugar Manufetus 3SP - Soins de sanapfar / Primary Health Care msu - Seually Trnmited Disea TDCI - Troubes Du ear Carncas an de Iodine Deficiency Diseses TRO - Ih Erapk de rfda"en par voe oral UCP - Unit d oorfinaton du projet 1 Project Coordini Unit UNDP - United Nations Development Programme UNFPA - Unitd Nations Fund for Populatn Acvies UNICEF - United Nations lntemaonad Children's Fund USAID - United Se Agecy for Inrnatinal Developm USC - Un W de souin des comosa VHW - Vllage Health Worker VITAL - Viamin A Fidd Support Project (JSAID) WHO - Wodtd Health O:anizaton WID - Women in Dealoment BURKINA EAS ', ALTH AND NUTRITON PROJECT fpdsn) TABLE OF CONTENTS Clr ET AND PROJCT SUMMARY...,.i I. 2.3 Maternal mortality is also high with 810 per 100,000 births (1988).

toa a I World Health Oaiza OR - Opeationa Reseah OSr - Ofca de sang ha auvai&ers I Bureau of Worker' Health PASE - Pogramme dppa a la su4weillanca ipudhmlgi q I Epidemiological Surveillaem Support Proje At PCU - Proect Coordinang Unit PDDS - Pk ide &wlppain & dibct Wa E I Dit Healh Development Plan PDSN - Proj.: devloppamaude sawn ade nurton I Hea and Nuti Development Poject PDSS - Proj es 4 dioppamaemes * ansfa de sam / Health Serviea Deveowmen Project PEG - Prevuuona Lc conrak dha and es goelsr a I Training Comm. About 18% of babies suffer from insufficient birthweight which limits their canaces of survival.

To address this risk, the Goverment has, prior to negotiations, developed a-d begun to implement an action plan, acceptable to IDA, to eosute the required redeployment and that the peonnel concerned reman where posted and carry out their assigned responsibilities.

= 270 CFAF (Rate prior to Janyary 12, 1994) Curmnt Rate = CFA Francl USSI = 580 CFAF WEIGHTS AND MEASURES Metric System I m. de sad pdmr I Primaq Health Care Post SA - Specal Accou SAFER - Soc#W ajhcbw d'icda a de Maksanom I Afica Firm for Stue sa Achievemnt Se P - Save the Childr Fund SPE - Sagqe mm d'di I Government Certified Mi A SIDA - Syndv me d'lmw Jfic cqids I AIDS SMI - Sawt mamelk aet infundk / Mote and Chld Heath SOEs - State of Expends_ SONAPHARM - Soc-M nanalk d'appavonmantph Iadque National Pharmaceul Supply Company SOSUCO - Soci Et acsq,v de Ia Como E I Como6 Company of Sugar Manufetus 3SP - Soins de sanapfar / Primary Health Care msu - Seually Trnmited Disea TDCI - Troubes Du ear Carncas an de Iodine Deficiency Diseses TRO - Ih Erapk de rfda"en par voe oral UCP - Unit d oorfinaton du projet 1 Project Coordini Unit UNDP - United Nations Development Programme UNFPA - Unitd Nations Fund for Populatn Acvies UNICEF - United Nations lntemaonad Children's Fund USAID - United Se Agecy for Inrnatinal Developm USC - Un W de souin des comosa VHW - Vllage Health Worker VITAL - Viamin A Fidd Support Project (JSAID) WHO - Wodtd Health O:anizaton WID - Women in Dealoment BURKINA EAS ', ALTH AND NUTRITON PROJECT fpdsn) TABLE OF CONTENTS Clr ET AND PROJCT SUMMARY...,.i I. 2.3 Maternal mortality is also high with 810 per 100,000 births (1988).

toa a I World Health Oaiza OR - Opeationa Reseah OSr - Ofca de sang ha auvai&ers I Bureau of Worker' Health PASE - Pogramme dppa a la su4weillanca ipudhmlgi q I Epidemiological Surveillaem Support Proje At PCU - Proect Coordinang Unit PDDS - Pk ide &wlppain & dibct Wa E I Dit Healh Development Plan PDSN - Proj.: devloppamaude sawn ade nurton I Hea and Nuti Development Poject PDSS - Proj es 4 dioppamaemes * ansfa de sam / Health Serviea Deveowmen Project PEG - Prevuuona Lc conrak dha and es goelsr a I Training Comm. About 18% of babies suffer from insufficient birthweight which limits their canaces of survival.

To address this risk, the Goverment has, prior to negotiations, developed a-d begun to implement an action plan, acceptable to IDA, to eosute the required redeployment and that the peonnel concerned reman where posted and carry out their assigned responsibilities.

High infant and materwal mortality levels are associated with inadequate pre-natal services, a low proportion of isttutionalized deliveries, and low detection and referral of high risk cases from the villages, where most deliveries are overseen by untrained traditional birth attendants under unsafe conditions.

In particular, the level of human resources development is extremely low (see Ann 1.1 for basic social indicators).

With a per capita GNP of about US0 in 1991, Burkina Faso is among the poorest counries in the world.

To address the procuement risk, the Government bas aprroved the required legislation and, with Bank assistance, establisbed CAMEO, an orgnizaon designed to undertake the importation and distribution of essential geric dregs.

It would also prevent recurrence of onchocerciasis and major outbreaks of human trypanosomiasis as well as eradicate draunculiasis which affects about 34% of the villages in Burlina-the highest prevalence of any Sahelian country. The first risk is that the expected procurement of essential generic dgs and their distribution may be slow to matialize.

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